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Montana rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Facilitymedian $3 · 10th–90th $2$1860%20%10th90th$3Professionalmedian $1 · 10th–90th $1$30%20%40%10th90th$1$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$100.00 / $141.25 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.14
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $46,773.51 / $91,201.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $1.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $4.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.62
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.58 / $1.62 / $4.37
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.58 / $1.62 / $4.37
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $4.17
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.51 / $1.62 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.41