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New York rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $47.86 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $6.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.82 / $1.86
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.86 / $1.86 / $1.95
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $1.86 / $1.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.70 / $1.70 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.82 / $7.41
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.70 / $2.19 / $3.98
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.95 / $1.95
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.82
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.82 / $1.82
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $2.04 / $5.50
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.91 / $1.91 / $1.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.82 / $2.75
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.51
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.82 / $2.51