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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
$1.42 / $1.42 / $1.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.42 / $2.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.15 / $1.55 / $1.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.46 / $1.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $1.85 / $3.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $7.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.93