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Maine rates for HCPCS A9604

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

Facilitymedian $3,890 · 10th–90th $3,090–$18,6210%20%10th90th$3,890Professionalmedian $16,596 · 10th–90th $15,488–$16,5960%50%10th$16,596$5.0K$10.0K$20.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $16,595.87 / $16,595.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,630.78 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,595.87 / $16,595.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $18,620.87 / $47,863.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $19,952.62
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $16,595.87 / $16,595.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $16,595.87 / $20,417.38