MultiHance contrast agent injection, 15 mL at Proctor Community Hospital

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

MULTIHANCE 529 MG/ML (0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION

Peoria, IL

See all hospitals reporting HCPCS A9577 →

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How this price compares nationally

Proctor Community Hospital’s median price of $180 is 2154% above the median hospital's median price ($8), higher than 87% 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 Proctor Community Hospital

Negotiated rates from the hospital’s own file: 7 payers, 18 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	Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient	$2	$2	—	—	—	$2 – $2
2	Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
3	UnitedHealthcare ppo other · outpatient	$116	$116	—	—	18	$116 – $116
4	Aetna Better Health managed medicaid percent of total billed charges · inpatientfrom % of charges	$133	$129	$53	41%	—	$55 – $195
5	Aetna Better Health managed medicaid percent of total billed charges · outpatientfrom % of charges	$133	$129	$53	41%	—	$55 – $195
6	Molina managed medicaid percent of total billed charges · inpatientfrom % of charges	$160	$155	$63	41%	—	$66 – $235
7	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$160	$155	$63	41%	—	$66 – $235
8	Molina medicare-medicaid (mmai/dual) percent of total billed charges · inpatientfrom % of charges	$160	$155	$63	41%	—	$66 – $235
9	Molina medicare-medicaid (mmai/dual) percent of total billed charges · outpatientfrom % of charges	$160	$155	$63	41%	—	$66 – $235
10	Blue Cross Blue Shield blue choice percent of total billed charges · outpatientfrom % of charges	$208	$202	$82	41%	36	$86 – $305
11	Blue Cross Blue Shield blue choice options percent of total billed charges · outpatientfrom % of charges	$208	$202	$82	41%	—	$86 – $305
12	Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges	$211	$204	$83	41%	133	$87 – $309
13	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$257	$249	$102	41%	—	$106 – $377
14	Aetna commercial ppo percent of total billed charges · outpatientfrom % of charges	$261	$253	$104	41%	—	$108 – $383
15	Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges	$267	$259	$106	41%	—	$110 – $391
16	MultiPlan ppo percent of total billed charges · inpatientfrom % of charges	$267	$259	$106	41%	—	$110 – $391
17	MultiPlan ppo percent of total billed charges · outpatientfrom % of charges	$267	$259	$106	41%	—	$110 – $391
18	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$357	$346	$142	41%	—	$148 – $524

Last updated: Apr 15, 2026

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