Gadoxetate contrast injection, 10 mL

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

GADOXETATE DISODIUM 0.25 MMOL/ML IV SOLN

Carefirst pricing summary

Low

$12

Average

$192

Median

$43

High

$763

Carefirst rate distribution

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30 hospital rates

#		Plans
1	NEMOURS CHILDREN'S HOSPITAL Philadelphia, PA percent of total billed charges · outpatientfrom % of charges	1	$203	$203	—	—	1–10	$203 – $203
2	Children's National Hospital Washington, DC facility · fee schedule · inpatient	2	$24	$24	—	—	—	$24 – $24
3	Children's National Hospital Washington, DC facility · fee schedule · outpatient	2	$38	$38	—	—	—	$38 – $38
4	Children's National Hospital Washington, DC facility · percent of total billed charges · inpatientfrom % of charges	1	$37	$37	—	—	—	$37 – $37
5	Children's National Hospital Washington, DC facility · percent of total billed charges · outpatientfrom % of charges	1	$31	$31	—	—	—	$31 – $31
6	Children's National Rehabilitation and Specialized Care Washington, DC facility · percent of total billed charges · inpatientfrom % of charges	2	$60	$60	$3	4%	—	$58 – $63
7	Children's National Rehabilitation and Specialized Care Washington, DC facility · percent of total billed charges · outpatientfrom % of charges	2	$60	$60	$3	4%	—	$58 – $63
8	Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges	3	$704	$692	$20	3%	—	$664 – $712
9	Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both	1	$763	$763	—	—	—	$763 – $763
10	Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges	3	$711	$698	$22	3%	—	$667 – $718
11	Inova Alexandria Hospital Alexandria, VA fee schedule · both	2	$23	$23	—	—	—	$23 – $23
12	Inova Fair Oaks Hospital Fairfax, VA fee schedule · both	2	$23	$23	—	—	—	$23 – $23
13	Inova Fairfax Hospital Falls Church, VA fee schedule · both	2	$23	$23	—	—	—	$23 – $23
14	Inova Loudoun Hospital Leesburg, VA fee schedule · both	2	$23	$23	—	—	—	$23 – $23
15	Inova Mount Vernon Hospital Alexandria, VA fee schedule · both	2	$23	$23	—	—	—	$23 – $23
16	MedStar Georgetown Hospital Washington, DC facility · fee schedule · outpatient	2	$39	$39	—	—	—	$39 – $39
17	MedStar Washington Hospital Center NW, WA facility · fee schedule · outpatient	2	$48	$48	—	—	—	$48 – $48
18	Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both	1	$255	$255	—	—	—	$255 – $255
19	National Rehabilitation Hospital Washington, WA facility · percent of total billed charges · inpatientfrom % of charges	2	$29	$29	$4	13%	—	$25 – $33
20	National Rehabilitation Hospital Washington, WA facility · percent of total billed charges · outpatientfrom % of charges	1	$31	$31	—	—	—	$31 – $31
21	Potomac Hospital Corporation of Prince William Lake Ridge, VA facility · fee schedule · outpatient	2	$22	$22	$1	6%	—	$20 – $23
22	RESTON HOSPITAL CENTER Reston, VA fee schedule · outpatient	2	$23	$23	—	—	—	$23 – $23
23	STONESPRINGS HOSPITAL CENTER Dulles, VA fee schedule · outpatient	2	$23	$23	—	—	—	$23 – $23
24	Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · fee schedule · both	1	$259	$259	—	—	—	$259 – $259
25	Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges	2	$223	$223	—	—	—	$223 – $223