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 Tricare 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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31 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $93.74 | $11.19 – $393.76 |
| 2 | Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $91.06 | $10.87 – $382.51 |
| 3 | Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $91.06 | $10.87 – $382.51 |
| 4 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $115.17 | $13.74 – $483.77 |
| 5 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $390.24 | $390.24 – $390.24 |
| 6 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $414.39 | $414.39 – $414.39 |
| 7 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $88.53 | $68.67 – $103.73 |
| 8 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $40.00 | $40.00 – $40.00 |
| 9 | HSA CGH LLC Coral Gables, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $12.39 | $12.39 – $12.39 |
| 10 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $390.24 | $390.24 – $390.24 |
| 11 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $138.23 | $76.68 – $266.95 |
| 12 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $133.28 | $77.42 – $269.48 |
| 13 | Mayo Clinic Health System Sparta, WI professional · fee schedule · outpatient | 1 | $20.90 | $20.90 – $20.90 |
| 14 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $168.56 | $168.56 – $168.56 |
| 15 | Morristown Medical Center Morristown, NJ other · outpatient | 2 | $414.39 | $414.39 – $414.39 |
| 16 | Newton Medical Center Newton, NJ other · outpatient | 2 | $390.24 | $390.24 – $390.24 |
| 17 | Northside Hospital, Inc. Lawrenceville, GA fee schedule · outpatient | 1 | $238.00 | $238.00 – $238.00 |
| 18 | Northside Hospital, Inc. Atlanta, GA fee schedule · outpatient | 1 | $238.00 | $238.00 – $238.00 |
| 19 | Northside Hospital, Inc. Cumming, GA fee schedule · outpatient | 1 | $238.00 | $238.00 – $238.00 |
| 20 | Northside Hospital, Inc. Duluth, GA fee schedule · outpatient | 1 | $238.00 | $238.00 – $238.00 |
| 21 | Northside Hospital, Inc. Canton, GA fee schedule · outpatient | 1 | $238.00 | $238.00 – $238.00 |
| 22 | Overlook Medical Center Summit, NJ other · outpatient | 2 | $414.39 | $414.39 – $414.39 |
| 23 | Penn Medicine Princeton Medical Center Princeton, NJ facility · fee schedule · outpatient | 1 | $249.67 | $84.00 – $930.00 |
| 24 | Pennsylvania Hospital of the University of Pennsylvania Health System Philadelphia, PA facility · fee schedule · outpatient | 1 | $249.67 | $84.00 – $930.00 |
| 25 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · fee schedule · outpatient | 1 | $249.67 | $84.00 – $930.00 |
← Payers reporting HCPCS A9575 · Snapshot 20261108T203506Z-bb90dbab