Code: A9576

Description:
Description: Injection, gadoteridol, (prohance multipack), per ml
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Other Descriptions:
HC INJECTION GADOTERIDOL PROHANCE MULTIPACK PER ML
GADOTERIDOL INJ 20ML
GADOTERIDOL INJ 5 ML
GADOTERIDOL INJ 10 ML
GADOTERIDOL PER 1ML
GADOTERIDOL PER ML
GADOTERIDOL (PROHANCE)PER
GADOTERIDOL (PROHANCE)
Gad-base Mr Contrast Nos,1ml
Related codes:
Code: A9570
IN111 AUTO WBC DX DOSE
Code: A9571
Description: Indium in-111 labeled autologous platelets, diagnostic, per study dose
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Code: A9572
IN111 PENTETREOT DX 6MCI
Code: A9575
GADOTERATE MEG 10 ML
Code: A9577
MULTIHANCE 5 ML
Code: A9578
MULTIHANCE MULTIPAC 1 ML
Code: A9579
GAD BASE MR CONT NOS 1ML
Idaho
Hospital Address Code Price Last Updated
Shoshone Medical Center 25 Jacobs Gulch Rd, Kellogg A9576 $7 [source] 4 years ago
Eastern Idaho Regional Medical Center 3100 Channing Way, Idaho Falls A9576 $25 [source] 4 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.