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South Dakota rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Facilitymedian $1 · 10th–90th $1$40%50%90th$1Professionalmedian $1 · 10th–90th $1$20%20%10th90th$1$1.0$2.0$5.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $3.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.58
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $1.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.45 / $1.45 / $1.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $2.40 / $3.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.23 / $1.41 / $1.55
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.70 / $1.70 / $1.70
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.55 / $1.55 / $1.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.95
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.41