Gadopiclenol contrast injection, per milliliter

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

GADOPICLENOL 0.5 MMOL/ML IV SOLN

Payers reporting HCPCS A9573

Payer pricing summary

Low

Average

$183

Median

$133

High

$817

Payer rate distribution

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#
1	Florida Blue percent of total billed charges · bothfrom % of charges	1	$59	$59	$10	17%	182–200	$50 – $76
2	Bcbs Sc percent of total billed charges · bothfrom % of charges	1	$43	$43	$6	14%	104	$36 – $49
3	Bcbs Wy percent of total billed charges · outpatientfrom % of charges	1	$248	$248	$200	81%	27	$58 – $592
4	Bcbs Il facility · other · inpatient · +4 other terms	1	$101	$101	—	—	1–10	$101 – $101
5	UnitedHealthcare fee schedule · outpatient · +20 other terms	348	$5	$61	$471	776%	—	$1 – $6.6k
6	Cigna fee schedule · outpatient · +19 other terms	284	$6	$31	$191	624%	—	$3 – $3.0k
7	Blue Cross Blue Shield fee schedule · outpatient · +19 other terms	171	$23	$25	$19	75%	—	$1 – $76
8	Humana fee schedule · outpatient · +16 other terms	120	$3	$13	$24	186%	—	$1 – $228
9	Aetna fee schedule · outpatient · +20 other terms	106	$9	$14	$20	136%	—	$1 – $231
10	Anthem fee schedule · outpatient · +17 other terms	59	$5	$68	$504	743%	—	$3 – $6.7k
11	Caresource fee schedule · outpatient · +11 other terms	49	$6	$13	$26	197%	—	$1 – $231
12	Kaiser fee schedule · both · +12 other terms	42	$4	$4	$1	26%	—	$3 – $6
13	Molina fee schedule · outpatient · +14 other terms	34	$9	$11	$29	255%	—	$1 – $226
14	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$681	$604	$282	47%	—	$268 – $1.1k
15	Superior Healthplan facility · percent of total billed charges · outpatientfrom % of charges	25	$158	$169	$94	56%	—	$48 – $467
16	MultiPlan fee schedule · inpatient · +10 other terms	21	$31	$527	$1.2k	223%	—	$12 – $6.6k
17	Healthpartners fee schedule · outpatient · +2 other terms	18	$4	$4	$0	2%	—	$4 – $4
18	Beechstreet percent of total billed charges · inpatientfrom % of charges · +3 other terms	16	$391	$401	$318	79%	—	$90 – $991
19	Devoted percent of total billed charges · outpatientfrom % of charges · +3 other terms	15	$531	$517	$220	43%	—	$5 – $1.3k
20	Medcost percent of total billed charges · outpatientfrom % of charges · +5 other terms	15	$247	$272	$266	98%	—	$20 – $1.8k
21	Bcbs Tx fee schedule · outpatient · +1 other terms	14	$45	$44	$11	26%	—	$19 – $63
22	Highmark facility · fee schedule · outpatient · +10 other terms	14	$3	$8	$6	71%	—	$3 – $20
23	Wellmark fee schedule · both · +4 other terms	14	$3	$4	$2	42%	—	$3 – $13
24	WellCare professional · fee schedule · outpatient · +10 other terms	13	$3	$3	$0	2%	—	$3 – $4
25	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +1 other terms	12	$478	$484	$163	34%	—	$47 – $1.1k

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