HCPCS A9577
Injection, gadobenate dimeglumine (multihance), per ml
Current code34 hospitals with prices
What Washington hospitals publish for this code
Other government program: TRICARE, VA, Indian Health Service, workers' compensation, or another public program.
| Hospital | Other government program rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $3.69 – $32.52 | $9.21 – $81.30 |
| Cascade Medical Center | $1.82 – $129 | $116 | $145 |
| Deaconess Medical Center | — | $4.43 – $51.24 | $11.07 – $128 |
| Highline Medical Center | — | $5.21 – $155 | $17.04 – $507 |
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | — | $111 | $159 |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | — | $8.00 | $20.00 |
| MultiCare Auburn Medical Center | — | $3.72 – $9.98 | $9.28 – $24.94 |
| MultiCare Covington Medical Center | — | $2.59 – $8.00 | $6.46 – $20.00 |
| MultiCare Good Samaritan Hospital | — | $3.98 – $8.00 | $9.95 – $20.00 |
| MultiCare Valley Hospital | — | $3.38 – $11.29 | $8.45 – $28.20 |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $63.00 | $90.00 |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | $63.00 | $90.00 |
| Providence Mount Carmel Hospital | — | $63.00 – $111 | $90.00 – $159 |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Joseph Hospital | — | $111 | $159 |
| Providence St Mary Medical Center | — | — | — |
| Providence St Peter Hospital | — | — | — |
| Seattle Children's Hospital | $283 | $690 | $690 |
| St Anthony Hospital | — | $5.19 – $154 | $17.04 – $507 |
| St Clare Hospital | — | $4.92 – $146 | $17.04 – $507 |
| St Elizabeth Hospital | — | $6.03 – $179 | $17.04 – $507 |
| St Francis Community Hospital | — | $5.35 – $159 | $17.04 – $507 |
| St Joseph Medical Center | — | $5.65 – $168 | $17.04 – $507 |
| St Michael Medical Center | — | $7.53 – $224 | $17.04 – $507 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | — | — |
| Swedish Medical Center | — | — | — |
| Swedish Medical Center / Cherry Hill | — | — | — |
| Tacoma General Allenmore Hospital | — | $2.50 – $10.18 | $6.25 – $25.44 |
| Yakima Valley Memorial | — | $4.30 – $12.66 | $10.73 – $31.65 |
Medicare (traditional) reference
CMS publishes no national amount for this code.