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
GADOXETATE DISODIUM 0.25 MMOL/ML IV SOLN
Low
$13
Average
$261
Median
$209
High
$718
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
57 hospitals; the 90th percentile is 47.1× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
64 hospital rates
iThe 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.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Mercy Hospital Logan County Inc Guthrie, OK facility · percent of total billed charges · outpatientfrom % of charges | 1 | $237 | $237 | — | — | 1–10 | $237 – $237 |
| 2 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $383 | $383 | $299 | 78% | — | $84 – $681 |
| 3 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $335 | $406 | $124 | 30% | — | $335 – $620 |
| 4 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 1 | $558 | $558 | — | — | — | $558 – $558 |
| 5 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $414 | $414 | — | — | — | $414 – $414 |
| 6 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $138 | $181 | $140 | 77% | — | $56 – $394 |
| 7 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $414 | $414 | — | — | — | $414 – $414 |
| 8 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $268 | $268 | — | — | — | $268 – $268 |
| 9 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $65 | $65 | — | — | — | $65 – $65 |
| 10 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 11 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · inpatientfrom % of charges | 1 | $208 | $208 | — | — | — | $208 – $208 |
| 12 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · outpatientfrom % of charges | 1 | $175 | $175 | — | — | — | $175 – $175 |
| 13 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $414 | $414 | — | — | — | $414 – $414 |
| 14 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $712 | $712 | — | — | — | $712 – $712 |
| 15 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $718 | $718 | — | — | — | $718 – $718 |
| 16 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · fee schedule · outpatient | 1 | $511 | $511 | — | — | — | $511 – $511 |
| 17 | Jefferson Health - Northeast Langhorne, PA facility · fee schedule · inpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 18 | Jefferson Health - Northeast Langhorne, PA facility · fee schedule · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 19 | Jefferson Health - Northeast Philadelphia, PA facility · fee schedule · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 20 | Kaweah Health Medical Center Visalia, CA facility · fee schedule · outpatient | 1 | $79 | $79 | $0 | 0% | — | $79 – $79 |
| 21 | Kaweah Health Mental Health Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $79 | $79 | $0 | 0% | — | $79 – $79 |
| 22 | Kaweah Health Rehabilitation Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 23 | Kennedy University Hospital, Inc Turnersville, NJ facility · fee schedule · inpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 24 | Kennedy University Hospital, Inc Turnersville, NJ facility · fee schedule · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 25 | Kennedy University Hospital, Inc Cherry Hill, NJ facility · fee schedule · inpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
← Payers reporting HCPCS A9581 · Snapshot 20261111T120946Z-9134e7f7