HCPCS A9575

Injection, gadoterate meglumine, 0.1 ml

Current code12 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 A9575 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
Cascade Medical CenterLeavenworth	$80.66 – $1214 plans	$116	$145
EvergreenHealth Medical CenterKirkland	—	$96.00 – $195	$120 – $244
EvergreenHealth MonroeMonroe	—	$106 – $107	$132 – $134
Providence Regional Medical Center EverettEverettFile dated 2026-04-01	—	$46.80	$90.00
Seattle Children's HospitalSeattle	$171 – $37412 plans	$666 – $1,150	$666 – $1,150
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01	—	$43.20	$90.00
WhidbeyHealth Medical CenterCoupeville	—	$140	$140

Lowest and highest amounts each hospital lists for this code as an outpatient, 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.