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Indiana rates for HCPCS A9577

Injection Gadobenate Dimeglumine (Multihance) Per Ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $94.77 / $229.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.76 / $1.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $3.48 / $5.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.74 / $2.47
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.61
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.18
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 / $5.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.31