go back

Oklahoma rates for HCPCS A9578

Injection, gadobenate dimeglumine (MultiHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.85 / $1.85 / $1.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $1.71 / $1.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.61 / $1.61 / $1.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $1.71 / $1.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.85 / $1.94 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $1.71 / $2.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $1.71 / $1.83