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Arizona rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.34 / $89.14 / $198.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.92 / $6.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.77 / $2.83 / $4.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.03 / $1.37 / $6.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $2.75 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $6.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.74