Gadopiclenol contrast injection, per milliliter at Southeast Texas - Jasper Memorial

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.

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Provider: anthropic
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Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

gadopiclenol (Vueway) 0.5 MMOL/ML injection 5 mL

Jasper, TX

See all hospitals reporting HCPCS A9573 →

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How this price compares nationally

Southeast Texas - Jasper Memorial’s median price of $417 is 5696% above the median hospital's median price ($7), higher than 94% of the 1,136 hospitals reporting HCPCS A9573. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9573 at Southeast Texas - Jasper Memorial

Negotiated rates from the hospital’s own file: 11 payers, 23 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 all payer fee schedule · outpatient	$3	$3	—	—	—	$3 – $3
2	UnitedHealthcare hix fee schedule · outpatient	$3	$3	—	—	—	$3 – $3
3	Bcbs Tx blue advantage hmo fee schedule · outpatient	$49	$49	—	—	—	$49 – $49
4	Bcbs Tx heb fee schedule · outpatient	$53	$53	—	—	—	$53 – $53
5	Bcbs Tx hmo fee schedule · outpatient	$53	$53	—	—	—	$53 – $53
6	Bcbs Tx ppo fee schedule · outpatient	$61	$61	—	—	—	$61 – $61
7	Bcbs Tx traditional fee schedule · outpatient	$63	$63	—	—	—	$63 – $63
8	UnitedHealthcare chip km percent of total billed charges · outpatientfrom % of charges	$157	$157	$42	27%	—	$105 – $208
9	UnitedHealthcare star kid km percent of total billed charges · outpatientfrom % of charges	$157	$157	$42	27%	—	$105 – $208
10	UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges	$157	$157	$42	27%	—	$105 – $208
11	UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges	$157	$157	$42	27%	—	$105 – $208
12	Aetna mm percent of total billed charges · outpatientfrom % of charges	$269	$269	$73	27%	—	$179 – $357
13	Molina chip km percent of total billed charges · outpatientfrom % of charges	$336	$336	$91	27%	—	$224 – $446
14	Molina star km percent of total billed charges · outpatientfrom % of charges	$336	$336	$91	27%	—	$224 – $446
15	Molina star plus km percent of total billed charges · outpatientfrom % of charges	$336	$336	$91	27%	—	$224 – $446
16	Cigna new business percent of total billed charges · outpatientfrom % of charges	$437	$436	$118	27%	—	$292 – $580
17	Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges	$505	$504	$136	27%	—	$336 – $670
18	Devoted mm percent of total billed charges · outpatientfrom % of charges	$561	$560	$151	27%	—	$374 – $744
19	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$673	$671	$181	27%	—	$448 – $893
20	Humana choicecare percent of total billed charges · outpatientfrom % of charges	$673	$671	$181	27%	—	$448 – $893
21	First Health ppo percent of total billed charges · outpatientfrom % of charges	$729	$727	$197	27%	—	$486 – $967
22	MultiPlan ppo percent of total billed charges · outpatientfrom % of charges	$729	$727	$197	27%	—	$486 – $967
23	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$729	$727	$197	27%	—	$486 – $967

Last updated: Jan 13, 2026

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