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New York rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $48.98 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $6.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.41
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.51
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.32 / $1.32 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $6.03
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.32 / $1.70 / $3.09
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.51 / $1.51
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.48
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.48 / $1.48
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.62 / $1.62 / $1.95
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.55 / $1.55 / $1.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $2.19
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.41 / $2.04
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.48 / $1.95