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North Dakota rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.15 / $1.55 / $1.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.45 / $1.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.86 / $2.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $7.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.58