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
GADOTERATE MEG 15 ML
Pasadena, TX
See all hospitals reporting HCPCS A9575 →Price type
HCA Houston Rehabilitation Hospital Southeast’s median price of $104 is 21711% 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, 25 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 | UnitedHealthcare allpayerappendix fee schedule · outpatient | $0.17 | $0.17 | $0.17 – $0.17 |
| 2 | UnitedHealthcare narrownetworkindivexchange fee schedule · outpatient | $0.17 | $0.17 | $0.17 – $0.17 |
| 3 | UnitedHealthcare smallgroup fee schedule · outpatient | $0.17 | $0.17 | $0.17 – $0.17 |
| 4 | Cigna csn fee schedule · outpatient | $0.29 | $0.29 | $0.29 – $0.29 |
| 5 | Cigna openaccessplus fee schedule · outpatient | $0.31 | $0.31 | $0.31 – $0.31 |
| 6 | Cigna ppo fee schedule · outpatient | $0.37 | $0.37 | $0.37 – $0.37 |
| 7 | Blue Cross Blue Shield mybluehealth fee schedule · outpatient | $0.39 | $0.39 | $0.39 – $0.39 |
| 8 | Blue Cross Blue Shield bav fee schedule · outpatient | $0.43 | $0.43 | $0.43 – $0.43 |
| 9 | Blue Cross Blue Shield eposoa fee schedule · outpatient | $0.54 | $0.54 | $0.54 – $0.54 |
| 10 | Blue Cross Blue Shield hmo fee schedule · outpatient | $0.54 | $0.54 | $0.54 – $0.54 |
| 11 | Blue Cross Blue Shield ppo fee schedule · outpatient | $0.54 | $0.54 | $0.54 – $0.54 |
| 12 | Humana hmo fee schedule · outpatient | $2.05 | $2.05 | $2.05 – $2.05 |
| 13 | Humana ppo fee schedule · outpatient | $2.05 | $2.05 | $2.05 – $2.05 |
| 14 | Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges | $22.21 | $25.27 | $11.48 – $42.13 |
| 15 | Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges | $22.21 | $25.27 | $11.48 – $42.13 |
| 16 | Superior Healthplan star percent of total billed charges · outpatientfrom % of charges | $22.21 | $25.27 | $11.48 – $42.13 |
| 17 | Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges | $22.21 | $25.27 | $11.48 – $42.13 |
| 18 | Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges | $22.21 | $25.27 | $11.48 – $42.13 |
| 19 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $74.77 | $85.08 | $38.64 – $141.84 |
| 20 | Molina hix percent of total billed charges · outpatientfrom % of charges | $99.94 | $113.72 | $51.65 – $189.58 |
| 21 | Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges | $129.55 | $147.42 | $66.96 – $245.76 |
| 22 | UnitedHealthcare globalappendix percent of total billed charges · outpatientfrom % of charges | $166.56 | $189.54 | $86.09 – $315.97 |
| 23 | First Health comm percent of total billed charges · outpatientfrom % of charges | $197.28 | $224.50 | $101.97 – $374.25 |
| 24 | Cigna commbh percent of total billed charges · outpatientfrom % of charges | $296.10 | $336.96 | $153.05 – $561.73 |
| 25 | MultiPlan complementaryppo percent of total billed charges · outpatientfrom % of charges | $333.12 | $379.08 | $172.18 – $631.94 |
Last updated: Mar 1, 2026
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