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North Carolina rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.69 / $70.04 / $188.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.83 / $110.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.87 / $6.02 / $7.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.35 / $1.80
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 / $3.46
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $2.70 / $6.61
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $2.58 / $2.58
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $2.96 / $7.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.29
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $85.00 / $100.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $12.00 / $12.00