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North Carolina rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Facilitymedian $30 · 10th–90th $1–$7590%5%10%10th90th$30Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$5.0$20.0$100.0$500.0

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
$1.23 / $29.51 / $758.58
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
$5.25 / $5.25 / $6.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.93 / $0.93 / $1.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.58 / $2.09 / $3.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.62
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $2.45
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $1.74 / $3.47
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $1,659.59
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $3.31 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $2.34 / $2.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.91
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $7.76