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Pennsylvania rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Facilitymedian $234 · 10th–90th $2$7240%10%10th90th$234Professionalmedian $1 · 10th–90th $1$30%50%90th$1$1.0$10.0$100.0$1.0K$10.0K

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
$1.82 / $295.12 / $851.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.82
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.75 / $6.76 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $6.76 / $6.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $4.90 / $5.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.38
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $1.51
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.38
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.58 / $2.40 / $3.80
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $60.26 / $64.57
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $3.72 / $3.72
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.55
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $158.49 / $371.54
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $1.51 / $3.02
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.71 / $1.62 / $10.72
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $1.62 / $10.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $3.09