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South Dakota rates for HCPCS A9578

Injection, gadobenate dimeglumine (MultiHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.71 / $1.71 / $1.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $1.71 / $1.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $1.84 / $2.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.45 / $2.89 / $6.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $1.71 / $1.88
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $2.33 / $2.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $2.17 / $4.59
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $1.87 / $1.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $1.71 / $1.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.71 / $1.71 / $1.71