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 MEGLUMINE 0.5 MMOL/ML (376.9 MG/ML) IV SOLN
Sandwich, IL
See all hospitals reporting HCPCS A9575 →Price type
Northwestern Medicine Valley West Hospital’s median price of $187 is 39228% above the median hospital's median price ($0), higher than 92% 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: 7 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 | Blue Cross Blue Shield vwh illinois medicaid percent of total billed charges · outpatientfrom % of charges | $33.64 | $31.90 | $6.50 – $53.82 |
| 2 | Cigna Healthspring vwh illinois medicaid percent of total billed charges · outpatientfrom % of charges | $33.64 | $31.90 | $6.50 – $53.82 |
| 3 | Blue Cross Blue Shield vwh blue cross medicare advt percent of total billed charges · outpatientfrom % of charges | $92.63 | $87.84 | $17.91 – $148.20 |
| 4 | Humana vwh medicare percent of total billed charges · outpatientfrom % of charges | $92.63 | $87.84 | $17.91 – $148.20 |
| 5 | Aetna vwh aetna nm employees percent of total billed charges · outpatientfrom % of charges | $123.83 | $117.43 | $23.94 – $198.12 |
| 6 | Aetna vwh aetna il preferred percent of total billed charges · outpatientfrom % of charges | $169.65 | $160.89 | $32.80 – $271.44 |
| 7 | Blue Cross Blue Shield vwh bcbs par/indemnity adp percent of total billed charges · outpatientfrom % of charges | $272.52 | $258.44 | $52.69 – $436.02 |
| 8 | Blue Cross Blue Shield vwh bcbs bluechoice options percent of total billed charges · outpatientfrom % of charges | $294.45 | $279.24 | $56.93 – $471.12 |
| 9 | Blue Cross Blue Shield vwh bcbs bluechoice select percent of total billed charges · outpatientfrom % of charges | $294.45 | $279.24 | $56.93 – $471.12 |
| 10 | Blue Cross Blue Shield vwh bcbs bluechoice preferred percent of total billed charges · outpatientfrom % of charges | $307.13 | $291.26 | $59.38 – $491.40 |
| 11 | Blue Cross Blue Shield vwh bcbs hmo percent of total billed charges · outpatientfrom % of charges | $317.61 | $301.20 | $61.40 – $508.17 |
| 12 | Aetna vwh aetna percent of total billed charges · outpatientfrom % of charges | $318.83 | $302.35 | $61.64 – $510.12 |
| 13 | Aetna vwh aetna asa percent of total billed charges · outpatientfrom % of charges | $337.84 | $320.39 | $65.32 – $540.54 |
| 14 | MultiPlan vwh phcs percent of total billed charges · outpatientfrom % of charges | $390.00 | $369.85 | $75.40 – $624.00 |
| 15 | Blue Cross Blue Shield vwh bcbs ppo percent of total billed charges · outpatientfrom % of charges | $398.29 | $377.71 | $77.00 – $637.26 |
| 16 | MultiPlan vwh multiplan percent of total billed charges · outpatientfrom % of charges | $426.57 | $404.53 | $82.47 – $682.50 |
| 17 | First Health vwh non-contracted payors percent of total billed charges · outpatientfrom % of charges | $487.50 | $462.31 | $94.25 – $780.00 |
| 18 | MultiPlan vwh non-contracted payors percent of total billed charges · outpatientfrom % of charges | $487.50 | $462.31 | $94.25 – $780.00 |
| 19 | UnitedHealthcare vwh uhc non-contracted oon - ed only percent of total billed charges · outpatientfrom % of charges | $487.50 | $462.31 | $94.25 – $780.00 |
Last updated: Apr 1, 2026
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