Oral MRI contrast agent, 100 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

Q9954

Cigna pricing summary

Low

Average

$162

Median

$16

High

$8.2k

Cigna rate distribution

Filter by billing methodology

Filter by billing class

91 hospital rates

#		Plans
1	Allina Health Systems Ulm, MN facility · other · outpatient	1	$113	$113	—	—	—	$113 – $113
2	Alomere Health Alexandria, MN facility · fee schedule · outpatient	1	$37	$37	—	—	—	$37 – $37
3	Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient	1	$8	$8	—	—	—	$8 – $8
4	CENTENNIAL HOSPITAL A CAMPUS OF TMCA ENGLEWOOD, CO percent of total billed charges · outpatientfrom % of charges	9	$9	$8	$3	39%	—	$4 – $11
5	Central Georgia Rehabilitation LLC Macon, GA fee schedule · both	1	$15	$15	—	—	—	$15 – $15
6	Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient	1	$8	$8	—	—	—	$8 – $8
7	Cheshire Medical Center Keene, NH professional · fee schedule · outpatient	2	$12	$12	—	—	—	$12 – $12
8	Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges	1	$20	$20	—	—	—	$20 – $20
9	DIGNITY COMMUNITY CARE Woodland, CA fee schedule · inpatient	2	$62	$62	$9	14%	—	$53 – $71
10	DIGNITY COMMUNITY CARE Woodland, CA fee schedule · outpatient	2	$62	$62	$9	14%	—	$53 – $71
11	ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · inpatient	1	$97	$97	—	—	—	$97 – $97
12	ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient	1	$89	$89	—	—	—	$89 – $89
13	Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient	1	$8	$8	—	—	—	$8 – $8
14	FRANCISCAN HEALTH SYSTEM Gig Harbor, WA fee schedule · inpatient	1	$97	$97	—	—	—	$97 – $97
15	FRANCISCAN HEALTH SYSTEM Gig Harbor, WA fee schedule · outpatient	1	$89	$89	—	—	—	$89 – $89
16	FRANCISCAN HEALTH SYSTEM Tacoma, WA fee schedule · inpatient	1	$97	$97	—	—	—	$97 – $97
17	FRANCISCAN HEALTH SYSTEM Tacoma, WA fee schedule · outpatient	1	$89	$89	—	—	—	$89 – $89
18	Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both	1	$14	$14	$1	9%	—	$13 – $15
19	Geisinger Bloomsburg Hospital Bloomsburg, PA percent of total billed charges · outpatientfrom % of charges	1	$3	$3	—	—	—	$3 – $3
20	Geisinger Community Medical Center Scranton, PA percent of total billed charges · outpatientfrom % of charges	1	$6	$6	—	—	—	$6 – $6
21	Geisinger Jersey Shore Hospital Jersey Shore, PA percent of total billed charges · outpatientfrom % of charges	1	$6	$6	—	—	—	$6 – $6
22	Geisinger Lewistown Hospital Lewistown, PA case rate · inpatient	1	$16.3k	$16.3k	—	—	—	$16.3k – $16.3k
23	Geisinger Lewistown Hospital Lewistown, PA percent of total billed charges · outpatientfrom % of charges	1	$2	$2	—	—	—	$2 – $2
24	Geisinger Medical Center Muncy, PA percent of total billed charges · outpatientfrom % of charges	1	$7	$7	—	—	—	$7 – $7
25	Geisinger Wyoming Valley Wilkes-Barre, PA percent of total billed charges · outpatientfrom % of charges	1	$6	$6	—	—	—	$6 – $6