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.
Original text from hospital filings
GADOTERATE MEGLUMINE 5 MMOL/10ML IV SOLN
The hospitals that file a Premera rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.
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22 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $233.62 | $181.21 – $273.74 |
| 2 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient | 1 | $356.43 | $356.43 – $356.43 |
| 3 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $136.84 | $75.90 – $264.26 |
| 4 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763.00 | $763.00 – $763.00 |
| 5 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $131.94 | $76.64 – $266.76 |
| 6 | Johnson Memorial Hospital Stafford Springs, CT facility · fee schedule · both | 1 | $168.35 | $168.35 – $168.35 |
| 7 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $9.37 | $9.37 – $9.37 |
| 8 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $64.10 | $64.10 – $64.10 |
| 9 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $23.96 | $9.58 – $38.34 |
| 10 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 1 | $22.00 | $22.00 – $22.00 |
| 11 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · outpatient | 1 | $356.43 | $356.43 – $356.43 |
| 12 | PORTLAND ADVENTIST MEDICAL CENTER Portland, OR percent of total billed charges · outpatientfrom % of charges | 1 | $127.39 | $127.39 – $127.39 |
| 13 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $65.63 | $65.63 – $65.63 |
| 14 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · fee schedule · both | 1 | $56.00 | $56.00 – $56.00 |
| 15 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $24.75 | $24.75 – $24.75 |
| 16 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 5 | $573.70 | $359.64 – $954.50 |
| 17 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · fee schedule · both | 1 | $24.98 | $8.92 – $35.68 |
| 18 | St Joseph Mercy Chelsea Chelsea, MI facility · fee schedule · both | 1 | $35.79 | $35.79 – $35.79 |
| 19 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI facility · fee schedule · both | 1 | $29.94 | $11.98 – $47.90 |
| 20 | St Joseph Mercy Oakland Pontiac, MI facility · fee schedule · both | 1 | $7.66 | $7.66 – $7.66 |
| 21 | St Mary Mercy Livonia Livonia, MI facility · fee schedule · both | 1 | $13.58 | $13.58 – $13.58 |
| 22 | St. Francis Hospital Inc Wilmington, DE facility · fee schedule · both | 1 | $34.50 | $34.50 – $34.50 |
← Payers reporting HCPCS A9575 · Snapshot 20261108T203506Z-bb90dbab