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

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for HCPCS A9575 by hospital
Hospital	Medicare Advantage rates (lowest – highest)	Cash price	List price (before discounts)
EvergreenHealth Medical CenterKirkland	—	$96.00 – $195	$120 – $244
EvergreenHealth MonroeMonroe	—	$106 – $107	$132 – $134
PeaceHealth Peace Island Medical CenterFriday Harbor	$6,305 – $6,9367 plans	$10.80 – $216	$16.62 – $332
PeaceHealth Southwest Medical CenteVancouver	—	$6.76 – $216	$10.40 – $332
PeaceHealth St John Medical CenterLongview	—	$10.80 – $216	$16.62 – $332
PeaceHealth St Joseph Medical CenterBellingham	—	$10.80 – $216	$16.62 – $332
PeaceHealth United General Medical CenterSedro Woolley	$3,312 – $3,6437 plans	$10.80 – $216	$16.62 – $332
Providence Regional Medical Center EverettEverettFile dated 2026-04-01	—	$46.80	$90.00
Seattle Children's HospitalSeattle	—	$666 – $1,150	$666 – $1,150
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01	—	$43.20	$90.00

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.