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Colorado 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
$15,631.57 / $15,631.57 / $15,631.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,631.57 / $15,631.57 / $18,562.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,848.22 / $28,332.21 / $52,105.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,697.40 / $16,608.54 / $16,608.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,183.86 / $16,217.75 / $28,136.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,282.88 / $16,282.88 / $16,282.88