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
Avon, OH
See all hospitals reporting HCPCS A9575 →Price type
Cleveland Clinic Avon Hospital’s median price of $6 is 1218% above the median hospital's median price ($0), higher than 65% 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: 9 payers, 19 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 acop facility · case rate · outpatient | $0.01 | $0.01 | $0.01 – $0.01 |
| 2 | Aetna acop facility · fee schedule · outpatient | $0.18 | $0.18 | $0.18 – $0.18 |
| 3 | Cigna all products facility · fee schedule · outpatient | $0.22 | $0.22 | $0.22 – $0.22 |
| 4 | Aetna international facility · fee schedule · outpatient | $0.23 | $0.23 | $0.23 – $0.23 |
| 5 | UnitedHealthcare all products facility · fee schedule · outpatient | $0.26 | $0.26 | $0.26 – $0.26 |
| 6 | Anthem ppo/hmo facility · percent of total billed charges · outpatientfrom % of charges | $2.02 | $2.07 | $0.39 – $3.46 |
| 7 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $2.59 | $2.65 | $0.49 – $4.42 |
| 8 | Oscar all products facility · percent of total billed charges · outpatientfrom % of charges | $3.36 | $3.44 | $0.64 – $5.74 |
| 9 | Oscar all products facility · percent of total billed charges · inpatientfrom % of charges | $4.29 | $4.39 | $0.82 – $7.32 |
| 10 | Anthem traditional facility · percent of total billed charges · outpatientfrom % of charges | $6.66 | $6.82 | $1.27 – $11.37 |
| 11 | Optum all products transplant facility · percent of total billed charges · outpatientfrom % of charges | $6.72 | $6.89 | $1.28 – $11.48 |
| 12 | Anthem traditional facility · percent of total billed charges · inpatientfrom % of charges | $6.87 | $7.04 | $1.31 – $11.73 |
| 13 | Aetna all products facility · percent of total billed charges · bothfrom % of charges | $8.91 | $9.12 | $1.70 – $15.21 |
| 14 | MultiPlan all products facility · percent of total billed charges · bothfrom % of charges | $10.69 | $10.95 | $2.04 – $18.25 |
| 15 | Aetna qhp/ipf facility · percent of total billed charges · bothfrom % of charges | $11.88 | $12.17 | $2.27 – $20.28 |
| 16 | Anthem managed medicaid facility · case rate · outpatient | $21.27 | $21.27 | $21.27 – $21.27 |
| 17 | Molina managed medicaid facility · case rate · outpatient | $21.27 | $21.27 | $21.27 – $21.27 |
| 18 | Caresource managed medicaid facility · case rate · outpatient | $21.68 | $21.68 | $21.68 – $21.68 |
| 19 | UnitedHealthcare managed medicaid facility · case rate · outpatient | $21.68 | $21.68 | $21.68 – $21.68 |
Last updated: Jun 15, 2026
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