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Utah rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Facilitymedian $2 · 10th–90th $2–$60%50%90th$2Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$5.0$20.0$100.0

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
$2.00 / $2.00 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.09 / $2.57 / $4.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $1.78 / $1.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $2.88 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $1.78 / $2.40
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.91 / $5.25
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $1.95 / $2.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82