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Missouri rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Facilitymedian $2 · 10th–90th $1–$130%10%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$2.0$5.0$10.0$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.41 / $4.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $3.89 / $13.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.41 / $1.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $1.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.58 / $2.57 / $3.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $2.69 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $1.41 / $2.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $1.91 / $2.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.41 / $1.78