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Idaho rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $81.81 / $303.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.76 / $2.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.64 / $1.74 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.74
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.18 / $4.90 / $10.59
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.85 / $3.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.64 / $3.55
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.09 / $2.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.78