A9573

Injection, gadopiclenol, 1 ml

Medicare pricing data for 250 providers across 20 states

🤖AI Overview

Prices vary significantly by location — from $2 in Rhode Island to $12 in Wisconsin. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Injection, gadopiclenol, 1 ml (HCPCS code A9573) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $6.66, but hospitals typically charge $14.75 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.33

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $6.66, your out-of-pocket cost would be approximately $1.33. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$6.66
Average Hospital Charge
$14.75
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$14.75
Medicare Allowed$6.66
Medicare Payment$5.30

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $5.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Wisconsin$12$1331428+78.5%
Indiana$12$122285+77.3%
Mississippi$11$60212,528+71.9%
Louisiana$11$622159+70.7%
Oklahoma$11$1113516+62.8%
Alaska$10$11101,508+55.7%
Massachusetts$10$426376+50.2%
Texas$10$103267+42.9%
California$9$94102+30.5%
Michigan$8$84124+13.4%
Washington$7$7201,367+4.2%
Illinois$6$61181-11.4%
Nebraska$6$69234-11.4%
New Jersey$5$572,731-27.6%
Arkansas$5$118318-31.1%
Virginia$4$4191-38.3%
New York$4$4352,002-38.6%
Pennsylvania$4$45507-40.4%
Florida$4$4504,428-45.9%
Rhode Island$2$2188-70.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber