HCPCS A9573

Injection, gadopiclenol, 1 ml

Current code17 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for HCPCS A9573 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
Providence St Peter HospitalOlympiaFile dated 2026-04-01	—	$70.77 – $88.47	$136 – $170
Seattle Children's HospitalSeattle	$107 – $41112 plans	$414 – $1,264	$414 – $1,264
Virginia Mason Medical CenterSeattle	—	$7.14	$14.00

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.