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Wyoming rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.19 / $120.23 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.31 / $3.89 / $3.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.32 / $1.32 / $1.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $2.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.41