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Montana rates for HCPCS A9579

Injection Gadolinium-Based Magnetic Resonance Contrast Agent Not Otherwise Specified (Nos) Per Ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.80 / $147.60 / $566.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.52 / $5.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.99 / $77,999.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.92 / $1.92 / $1.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.71 / $1.71 / $4.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.48 / $1.71
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.71 / $1.71 / $4.53
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.60 / $1.60 / $1.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.48 / $1.48