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Massachusetts rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $6.95 / $127.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.81
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.02 / $5.58 / $100.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $5.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.79 / $4.86 / $8.81
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 / $1.74
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.06 / $83.43 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.81
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $12.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $5.36