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Maryland rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $5.47 / $5.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.74 / $44.41
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.74 / $2.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.82
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.82 / $2.00