go back

Utah rates for HCPCS A9581

Injection, gadoxetate disodium, 1 ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $436.52 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $14.13 / $16.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $21.38 / $22.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $14.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.78 / $19.50 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $19.50
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.49 / $18.62
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $14.79 / $17.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $14.79