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Ohio rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Facilitymedian $60 · 10th–90th $2–$1410%10%10th90th$60Professionalmedian $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
$2.69 / $77.62 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $3.02 / $9.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.74 / $2.69
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.41
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $1.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.63 / $2.95 / $4.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $3.09
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.60 / $1.32 / $8.91
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $3.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.78 / $2.63
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.45 / $2.63 / $3.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $3.09 / $3.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.66