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
DRAXIMAGE MDP-25 25 MG INTRAVENOUS SOLUTION
Normal, IL
See all hospitals reporting HCPCS A9503 →Price type
Carle BroMenn Medical Center’s median price of $170 is 88% above the median hospital's median price ($90), higher than 75% of the 2,017 hospitals reporting HCPCS A9503. 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, 17 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 | Humana medicare-medicaid (d-snp) fee schedule · inpatient | $12 | $12 | — | — | — | $12 – $12 |
| 2 | Humana medicare-medicaid (d-snp) fee schedule · outpatient | $12 | $12 | — | — | — | $12 – $12 |
| 3 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $13 | $13 | — | — | — | $13 – $13 |
| 4 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 5 | UnitedHealthcare va ccn/optum fee schedule · inpatient | $26 | $26 | — | — | — | $26 – $26 |
| 6 | UnitedHealthcare va ccn/optum fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 7 | Molina managed medicaid percent of total billed charges · inpatientfrom % of charges | $294 | $294 | $239 | 81% | — | $55 – $533 |
| 8 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $294 | $294 | $239 | 81% | — | $55 – $533 |
| 9 | Molina medicare-medicaid (d-snp) percent of total billed charges · inpatientfrom % of charges | $294 | $294 | $239 | 81% | — | $55 – $533 |
| 10 | Molina medicare-medicaid (d-snp) percent of total billed charges · outpatientfrom % of charges | $294 | $294 | $239 | 81% | — | $55 – $533 |
| 11 | Blue Cross Blue Shield blue choice/options/ppo percent of total billed charges · outpatientfrom % of charges | $904 | $904 | $735 | 81% | 24 | $169 – $1.6k |
| 12 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $907 | $907 | $738 | 81% | 2–20 | $169 – $1.6k |
| 13 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $911 | $911 | $741 | 81% | — | $170 – $1.7k |
| 14 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $911 | $911 | $741 | 81% | — | $170 – $1.7k |
| 15 | Aetna ppo percent of total billed charges · inpatientfrom % of charges | $972 | $972 | $790 | 81% | — | $181 – $1.8k |
| 16 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $972 | $972 | $790 | 81% | — | $181 – $1.8k |
| 17 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | $897 | 81% | — | $206 – $2.0k |
Last updated: Apr 15, 2026
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