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) INTRAVENOUS SOLUTION
Troy, NY
See all hospitals reporting HCPCS A9575 →Price type
Samaritan Hospital’s median price of $25 is 5111% above the median hospital's median price ($0), higher than 70% 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: 15 payers, 26 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 | UnitedHealthcare united healthcare medicaid harp chip facility · fee schedule · both | $12.36 | $12.36 | $12.36 – $12.36 |
| 2 | Cigna cigna facility · fee schedule · both | $23.18 | $23.18 | $23.18 – $23.18 |
| 3 | Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 4 | Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 5 | Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 6 | Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 7 | Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 8 | Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 9 | Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 10 | Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 11 | Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 12 | Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 13 | Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 14 | Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $24.75 | $24.75 | $24.75 – $24.75 |
| 15 | Aetna aetna facility · fee schedule · both | $33.99 | $33.99 | $33.99 – $33.99 |
| 16 | Medical Mutual aetna facility · fee schedule · both | $33.99 | $33.99 | $33.99 – $33.99 |
| 17 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $34.88 | $34.88 | $24.75 – $45.00 |
| 18 | First Health first health facility · percent of total billed charges · bothfrom % of charges | $36.00 | $36.00 | $36.00 – $36.00 |
| 19 | MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges | $40.50 | $40.50 | $40.50 – $40.50 |
| 20 | MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges | $40.50 | $40.50 | $40.50 – $40.50 |
| 21 | Phcs multiplan facility · percent of total billed charges · bothfrom % of charges | $40.50 | $40.50 | $40.50 – $40.50 |
| 22 | UnitedHealthcare uhc essential plan medicaid facility · fee schedule · both | $42.00 | $42.00 | $42.00 – $42.00 |
| 23 | Anthem empire medicaid facility · percent of total billed charges · bothfrom % of charges | $45.00 | $45.00 | $45.00 – $45.00 |
| 24 | Anthem empire medicaid essential 1 2 3 4 facility · percent of total billed charges · bothfrom % of charges | $45.00 | $45.00 | $45.00 – $45.00 |
| 25 | Excellus empire medicaid facility · percent of total billed charges · bothfrom % of charges | $45.00 | $45.00 | $45.00 – $45.00 |
Last updated: Mar 31, 2026
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