go back

Wisconsin rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Facilitymedian $112 · 10th–90th $4–$5010%5%10%10th90th$112Professionalmedian $2 · 10th–90th $1–$660%20%10th90th$2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$4.37 / $120.23 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $72.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $1.78 / $2.63
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.63 / $2.63 / $2.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.40 / $4.47 / $6.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $2.45 / $3.63
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $2.00
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.86 / $1.86 / $2.00
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $6.76 / $28.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $6.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $50.12 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.95 / $1.95 / $1.95
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $3.24
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $2.57 / $5.50
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $2.88 / $12.02
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.40 / $2.40 / $2.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $4.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $2.14 / $6.31