MultiHance contrast agent injection, 15 mL at Quitman Hospital, LLC

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

Quitman, TX

See all hospitals reporting HCPCS A9577 →

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How this price compares nationally

Quitman Hospital, LLC’s median price of $192 is 2296% above the median hospital's median price ($8), higher than 87% of the 1,604 hospitals reporting HCPCS A9577. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9577 at Quitman Hospital, LLC

Negotiated rates from the hospital’s own file: 9 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 blue cross medicare advantage oos [116005] facility · percent of total billed charges · bothfrom % of charges	$107	$107	—	—	—	$107 – $107
2	Cigna cigna medicare replacement [126500] facility · percent of total billed charges · bothfrom % of charges	$107	$107	—	—	—	$107 – $107
3	Humana humana medicare advantage/ppo/gold [152503] facility · percent of total billed charges · bothfrom % of charges	$107	$107	—	—	—	$107 – $107
4	Medicare medicare part a and b [163500] facility · percent of total billed charges · bothfrom % of charges	$107	$107	—	—	—	$107 – $107
5	Medicare medicare part a only [163502] facility · percent of total billed charges · bothfrom % of charges	$107	$107	—	—	—	$107 – $107
6	Medicare medicare part b only [163501] facility · percent of total billed charges · bothfrom % of charges	$107	$107	—	—	—	$107 – $107
7	WellCare wellcare medicare [377501] facility · percent of total billed charges · bothfrom % of charges	$107	$107	—	—	—	$107 – $107
8	Aetna aetna coventry medicare replacement [102002] facility · percent of total billed charges · bothfrom % of charges	$110	$110	—	—	—	$110 – $110
9	UnitedHealthcare uhc medicare advantage [206511] facility · percent of total billed charges · bothfrom % of charges	$110	$110	—	—	—	$110 – $110
10	Ambetter ambetter [293000] facility · percent of total billed charges · bothfrom % of charges	$123	$123	—	—	—	$123 – $123
11	Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges	$192	$192	—	—	—	$192 – $192
12	Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges	$192	$192	—	—	—	$192 – $192
13	Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges	$192	$192	—	—	—	$192 – $192
14	Blue Cross Blue Shield bcbs medicaid [116504] facility · percent of total billed charges · bothfrom % of charges	$255	$255	—	—	—	$255 – $255
15	Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges	$255	$255	—	—	—	$255 – $255
16	UnitedHealthcare uhc medicaid community plan [375501] facility · percent of total billed charges · bothfrom % of charges	$255	$255	—	—	—	$255 – $255
17	UnitedHealthcare uhc medica choice [206030] facility · percent of total billed charges · bothfrom % of charges	$384	$384	—	—	—	$384 – $384
18	UnitedHealthcare united healthcare student svc [206012] facility · percent of total billed charges · bothfrom % of charges	$384	$384	—	—	—	$384 – $384
19	UnitedHealthcare united healthcare texas exchange plan [206034] facility · percent of total billed charges · bothfrom % of charges	$384	$384	—	—	—	$384 – $384

Last updated: Feb 12, 2026

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