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
Cleveland, OH
See all hospitals reporting HCPCS A9575 →Price type
Cleveland Clinic Children's Hospital For Rehabilitation’s median price of $10 is 1923% above the median hospital's median price ($0), higher than 67% 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, 26 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 | Oscar all products facility · percent of total billed charges · outpatientfrom % of charges | $5.09 | $4.61 | $2.85 – $5.74 |
| 2 | Oscar all products facility · percent of total billed charges · inpatientfrom % of charges | $6.50 | $5.88 | $3.64 – $7.32 |
| 3 | Cigna all products facility · percent of total billed charges · bothfrom % of charges | $6.66 | $6.03 | $3.73 – $7.50 |
| 4 | Anthem hpn facility · percent of total billed charges · outpatientfrom % of charges | $7.54 | $6.82 | $4.22 – $8.49 |
| 5 | Anthem hpn facility · percent of total billed charges · inpatientfrom % of charges | $7.78 | $7.04 | $4.36 – $8.76 |
| 6 | Optum all products transplant facility · percent of total billed charges · outpatientfrom % of charges | $8.46 | $7.66 | $4.74 – $9.53 |
| 7 | Anthem traditional facility · percent of total billed charges · outpatientfrom % of charges | $8.58 | $7.77 | $4.81 – $9.67 |
| 8 | UnitedHealthcare all products facility · percent of total billed charges · bothfrom % of charges | $8.66 | $7.84 | $4.85 – $9.75 |
| 9 | Optum commercial chd care solutions facility · percent of total billed charges · bothfrom % of charges | $8.68 | $7.85 | $4.86 – $9.77 |
| 10 | Anthem traditional facility · percent of total billed charges · inpatientfrom % of charges | $8.85 | $8.01 | $4.96 – $9.98 |
| 11 | Anthem ppo/hmo facility · percent of total billed charges · outpatientfrom % of charges | $8.87 | $8.03 | $4.97 – $9.99 |
| 12 | Anthem ppo/hmo facility · percent of total billed charges · inpatientfrom % of charges | $9.15 | $8.28 | $5.12 – $10.31 |
| 13 | Optum commercial crs care solutions facility · percent of total billed charges · bothfrom % of charges | $9.20 | $8.33 | $5.15 – $10.36 |
| 14 | Aetna all products facility · percent of total billed charges · bothfrom % of charges | $13.50 | $12.22 | $7.56 – $15.21 |
| 15 | Aetna acop facility · percent of total billed charges · outpatientfrom % of charges | $14.08 | $12.74 | $7.88 – $15.86 |
| 16 | Cigna all products psychiatrist facility · percent of total billed charges · outpatientfrom % of charges | $14.40 | $13.03 | $8.06 – $16.22 |
| 17 | Aetna asa_whirlpool_peia (hmo) facility · percent of total billed charges · outpatientfrom % of charges | $16.20 | $14.66 | $9.07 – $18.25 |
| 18 | MultiPlan all products facility · percent of total billed charges · bothfrom % of charges | $16.20 | $14.66 | $9.07 – $18.25 |
| 19 | Aetna international facility · percent of total billed charges · outpatientfrom % of charges | $17.10 | $15.48 | $9.58 – $19.27 |
| 20 | Aetna asa_whirlpool_peia (pos_epo_ppo) facility · percent of total billed charges · outpatientfrom % of charges | $17.17 | $15.54 | $9.62 – $19.35 |
| 21 | Aetna qhp/ipf facility · percent of total billed charges · bothfrom % of charges | $18.00 | $16.29 | $10.08 – $20.28 |
| 22 | Optum managed medicaid transplant facility · case rate · outpatient | $34.72 | $34.72 | $34.72 – $34.72 |
| 23 | Anthem managed medicaid facility · case rate · outpatient | $38.38 | $38.38 | $38.38 – $38.38 |
| 24 | Molina managed medicaid facility · case rate · outpatient | $38.38 | $38.38 | $38.38 – $38.38 |
| 25 | Caresource managed medicaid facility · case rate · outpatient | $39.11 | $39.11 | $39.11 – $39.11 |
Last updated: Jun 15, 2026
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