MultiHance contrast agent injection, 15 mL at Mercy Hospital Fort Smith

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

GADOBENATE DIMEGLUMINE 529 MG/ML(0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION

Smith, AR

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How this price compares nationally

Mercy Hospital Fort Smith’s median price of $63 is 692% above the median hospital's median price ($8), higher than 73% of the 1,614 hospitals reporting HCPCS A9577. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9577 at Mercy Hospital Fort Smith

Negotiated rates from the hospital’s own file: 8 payers, 11 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	Anthem hb ftsm blue cross facility · fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
2	Blue Cross Blue Shield hb ftsm bcbs exchange facility · fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
3	Blue Cross Blue Shield hb ftsm blue cross facility · fee schedule · outpatient	$10	$10	—	—	—	$10 – $10
4	Medicaid hb ftsm ark medicaid facility · fee schedule · outpatient	$14	$14	—	—	—	$14 – $14
5	Caresource hb ftsm caresource medicaid facility · fee schedule · outpatient	$15	$15	—	—	—	$15 – $15
6	Cigna hb ftsm cigna facility · fee schedule · outpatient	$17	$17	—	—	—	$17 – $17
7	Medicaid hb ftsm mo medicaid facility · percent of total billed charges · outpatientfrom % of charges	$28	$28	—	—	—	$28 – $28
8	Aetna hb ftsm ok managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$35	$35	—	—	—	$35 – $35
9	Humana hb ftsm ok managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$35	$35	—	—	—	$35 – $35
10	Humana hb ftsm humana facility · percent of total billed charges · outpatientfrom % of charges	$106	$106	—	—	—	$106 – $106
11	MultiPlan hb ftsm,wldar,ozkar,prsar multi plan facility · percent of total billed charges · outpatientfrom % of charges	$120	$120	—	—	15	$120 – $120

Last updated: Jun 8, 2026

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