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Nebraska rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $71.33 / $313.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $27.30
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.83 / $1.83 / $1.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.67 / $1.97 / $222.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $1.97 / $1.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $2.19 / $2.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $2.18 / $2.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.41 / $4.88 / $34.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $6.31
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.08 / $2.21 / $2.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.09 / $2.44 / $4.37
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.10 / $3.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.65 / $1.74 / $2.61