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West Virginia rates for HCPCS A9577

Injection, gadobenate dimeglumine (MultiHance), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.93 / $271.36 / $397.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.74 / $1.76
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $2.61 / $2.61
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.09 / $4.03 / $4.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.64 / $1.74 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $3.46
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.05 / $8.15 / $12.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $6.31