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 VIAL 20ML
Atlanta, GA
See all hospitals reporting HCPCS A9575 →Price type
Northside Hospital, Inc.’s median price of $155 is 32468% above the median hospital's median price ($0), higher than 90% 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, 56 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 | Blue Cross Blue Shield bcbs_pathway fee schedule · outpatient | $3.20 | $3.20 | $3.20 – $3.20 |
| 2 | Blue Cross Blue Shield bcbs_pathway-l fee schedule · outpatient | $3.20 | $3.20 | $3.20 – $3.20 |
| 3 | Blue Cross Blue Shield bcbs_hmo fee schedule · outpatient | $6.10 | $6.10 | $6.10 – $6.10 |
| 4 | Blue Cross Blue Shield bcbs_hmo-l fee schedule · outpatient | $6.10 | $6.10 | $6.10 – $6.10 |
| 5 | Blue Cross Blue Shield blue hpn fee schedule · outpatient | $6.24 | $6.24 | $6.24 – $6.24 |
| 6 | Blue Cross Blue Shield blue hpn-l fee schedule · outpatient | $6.24 | $6.24 | $6.24 – $6.24 |
| 7 | UnitedHealthcare uhc ga individual exchange fee schedule · outpatient | $6.60 | $6.60 | $6.60 – $6.60 |
| 8 | UnitedHealthcare uhc heritage select fee schedule · outpatient | $6.60 | $6.60 | $6.60 – $6.60 |
| 9 | UnitedHealthcare uhc hmo/pos/ppo fee schedule · outpatient | $6.60 | $6.60 | $6.60 – $6.60 |
| 10 | UnitedHealthcare uhc hmo/pos/ppo-g fee schedule · outpatient | $6.60 | $6.60 | $6.60 – $6.60 |
| 11 | UnitedHealthcare uhc hmo/pos/ppo-t fee schedule · outpatient | $6.60 | $6.60 | $6.60 – $6.60 |
| 12 | Blue Cross Blue Shield bcbs_ppo fee schedule · outpatient | $9.60 | $9.60 | $9.60 – $9.60 |
| 13 | Blue Cross Blue Shield bcbs_ppo-l fee schedule · outpatient | $9.60 | $9.60 | $9.60 – $9.60 |
| 14 | Cigna cigna healthsprings medicare advantage other · outpatient | $38.85 | $38.85 | $38.85 – $38.85 |
| 15 | Caresource caresource other · outpatient | $44.54 | $44.54 | $44.54 – $44.54 |
| 16 | Caresource caresource marketplace percent of total billed charges · inpatientfrom % of charges | $88.54 | $88.54 | $88.54 – $88.54 |
| 17 | Caresource caresource marketplace percent of total billed charges · outpatientfrom % of charges | $88.54 | $88.54 | $88.54 – $88.54 |
| 18 | Oscar oscar percent of total billed charges · inpatientfrom % of charges | $119.00 | $119.00 | $119.00 – $119.00 |
| 19 | Oscar oscar percent of total billed charges · outpatientfrom % of charges | $119.00 | $119.00 | $119.00 – $119.00 |
| 20 | Kaiser kaiser_hmo percent of total billed charges · outpatientfrom % of charges | $154.70 | $154.70 | $154.70 – $154.70 |
| 21 | Kaiser kaiser_hmo-aga percent of total billed charges · outpatientfrom % of charges | $154.70 | $154.70 | $154.70 – $154.70 |
| 22 | Kaiser kaiser_hmo-bariatric percent of total billed charges · outpatientfrom % of charges | $154.70 | $154.70 | $154.70 – $154.70 |
| 23 | Kaiser kaiser_hmo-gcs percent of total billed charges · outpatientfrom % of charges | $154.70 | $154.70 | $154.70 – $154.70 |
| 24 | Kaiser kaiser_hmo-gpg/noas percent of total billed charges · outpatientfrom % of charges | $154.70 | $154.70 | $154.70 – $154.70 |
| 25 | Kaiser kaiser_hmo-gynonc percent of total billed charges · outpatientfrom % of charges | $154.70 | $154.70 | $154.70 – $154.70 |
Last updated: Feb 14, 2026
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