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Massachusetts rates for HCPCS A9604

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

Facilitymedian $18,621 · 10th–90th $10,965–$35,4810%20%10th90th$18,621Professionalmedian $16,596 · 10th–90th $15,488–$23,4420%50%10th90th$16,596$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $16,595.87 / $19,498.45
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,964.78 / $11,748.98 / $19,054.61
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $16,218.10 / $43,651.58
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,620.87 / $18,620.87 / $37,153.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $35,481.34 / $72,443.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $4,466.84 / $7,079.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $26,915.35
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,964.78 / $11,748.98 / $19,054.61
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $16,218.10 / $43,651.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $4,265.80 / $9,332.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,595.87 / $19,498.45