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
DOTAREM 10MMOL/20ML INJ
Barbourville, KY
See all hospitals reporting HCPCS A9575 →Price type
ARH Mary Breckinridge Health Services, Inc’s median price of $104 is 21769% above the median hospital's median price ($0), higher than 86% of the 1,486 hospitals reporting HCPCS A9575. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 14 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Anthem commercial fee schedule · outpatient | $0.14 | $0.14 | $0.14 – $0.14 |
| 2 | Aetna Better Health medicaid percent of total billed charges · outpatientfrom % of charges | $99.03 | $99.03 | $95.20 – $102.85 |
| 3 | Anthem medicaid percent of total billed charges · outpatientfrom % of charges | $99.03 | $99.03 | $95.20 – $102.85 |
| 4 | Humana medicaid percent of total billed charges · outpatientfrom % of charges | $99.03 | $99.03 | $95.20 – $102.85 |
| 5 | Anthem medicare advantage percent of total billed charges · outpatientfrom % of charges | $100.02 | $100.02 | $96.15 – $103.88 |
| 6 | Humana medicare percent of total billed charges · outpatientfrom % of charges | $100.02 | $100.02 | $96.15 – $103.88 |
| 7 | Optum veterans affairs plan percent of total billed charges · outpatientfrom % of charges | $100.02 | $100.02 | $96.15 – $103.88 |
| 8 | WellCare medicaid percent of total billed charges · outpatientfrom % of charges | $100.02 | $100.02 | $96.15 – $103.88 |
| 9 | WellCare medicare percent of total billed charges · outpatientfrom % of charges | $100.02 | $100.02 | $96.15 – $103.88 |
| 10 | Molina medicaid percent of total billed charges · outpatientfrom % of charges | $101.01 | $101.01 | $97.10 – $104.91 |
| 11 | Aetna medicare percent of total billed charges · outpatientfrom % of charges | $139.80 | $139.80 | $134.40 – $145.20 |
| 12 | UnitedHealthcare medicare percent of total billed charges · outpatientfrom % of charges | $168.93 | $168.93 | $162.40 – $175.45 |
| 13 | UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges | $259.80 | $259.80 | $249.76 – $269.83 |
| 14 | Aetna commercial percent of total billed charges · bothfrom % of charges | $512.60 | $512.60 | $492.80 – $532.40 |
Last updated: Jan 1, 2026
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