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Mississippi rates for HCPCS A9576

Injection Gadoteridol (Prohance Multipack) Per Ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.49 / $1.70 / $63.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.49 / $23.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $2.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.36 / $1.42 / $1.85