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Virginia rates for HCPCS A9577

Injection Gadobenate Dimeglumine (Multihance) Per Ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $179.40 / $569.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.83 / $2.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.13
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $4.29
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.97 / $2.31
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $2.40 / $3.49
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.41 / $3.27 / $5.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.65 / $2.11 / $5.99
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.65 / $2.11 / $5.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $2.18