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Oklahoma rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.14 / $191.49 / $510.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.97 / $1.97 / $1.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.64 / $1.64 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.88 / $2.52 / $21.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.86