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 0.5 MMOL/ML (376.9 MG/ML) INTRAVENOUS SOLUTION
Normal, IL
See all hospitals reporting HCPCS A9575 →Price type
Carle BroMenn Medical Center’s median price of $162 is 33936% above the median hospital's median price ($0), higher than 91% 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, 15 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 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $0.13 | $0.13 | $0.13 – $0.13 |
| 2 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $0.13 | $0.13 | $0.13 – $0.13 |
| 3 | Humana medicare-medicaid (d-snp) fee schedule · inpatient | $0.13 | $0.13 | $0.13 – $0.13 |
| 4 | Humana medicare-medicaid (d-snp) fee schedule · outpatient | $0.13 | $0.13 | $0.13 – $0.13 |
| 5 | Molina managed medicaid percent of total billed charges · inpatientfrom % of charges | $83.82 | $140.07 | $44.64 – $711.02 |
| 6 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $83.82 | $140.07 | $44.64 – $711.02 |
| 7 | Molina medicare-medicaid (d-snp) percent of total billed charges · inpatientfrom % of charges | $83.82 | $140.07 | $44.64 – $711.02 |
| 8 | Molina medicare-medicaid (d-snp) percent of total billed charges · outpatientfrom % of charges | $83.82 | $140.07 | $44.64 – $711.02 |
| 9 | Blue Cross Blue Shield blue choice/options/ppo percent of total billed charges · outpatientfrom % of charges | $257.76 | $430.73 | $137.27 – $2,186 |
| 10 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $258.60 | $432.13 | $137.71 – $2,193 |
| 11 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $259.85 | $434.23 | $138.38 – $2,204 |
| 12 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $259.85 | $434.23 | $138.38 – $2,204 |
| 13 | Aetna ppo percent of total billed charges · inpatientfrom % of charges | $277.04 | $462.95 | $147.54 – $2,350 |
| 14 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $277.04 | $462.95 | $147.54 – $2,350 |
| 15 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $314.34 | $525.28 | $167.40 – $2,666 |
Last updated: Apr 15, 2026
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