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Louisiana rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.76 / $3.69 / $330.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.76 / $2.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.78 / $3.18 / $3.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.04
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $69.45 / $69.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.64 / $1.64 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $3.63