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New Jersey rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.42 / $14.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.67 / $2.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.47
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.46 / $1.54 / $1.54
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.62