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Arkansas rates for HCPCS A9604

Samarium Sm-153 lexidronam, therapeutic, per treatment dose, up to 150 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,217.75 / $16,608.54 / $16,608.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,562.49 / $18,562.49 / $18,562.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,562.49 / $18,562.49 / $18,562.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,245.83 / $16,608.54 / $16,608.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,282.88 / $16,282.88 / $17,620.68