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New Hampshire rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Facilitymedian $3 · 10th–90th $2–$1700%20%10th90th$3Professionalmedian $2 · 10th–90th $1–$30%50%10th90th$2$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.82 / $2.14 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.51 / $3.72 / $6.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $1.78 / $2.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $3.55 / $4.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $1.78 / $1.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $1.78 / $3.39
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $1.82 / $2.75