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Hawaii rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.47 / $150.47 / $227.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.73 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.19
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $2.66 / $2.66
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.09 / $2.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.19 / $2.61
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $1.84 / $2.33