go back

Michigan rates for HCPCS A9604

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

Facilitymedian $16,982 · 10th–90th $3,162–$40,7380%10%10th90th$16,982Professionalmedian $16,218 · 10th–90th $15,488–$19,0550%50%10th90th$16,218$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
Facility
Modifier
Typical Low / Median / Typical High
$15,488.17 / $15,488.17 / $15,488.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $16,218.10 / $16,595.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $25,118.86 / $43,651.58
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $15,488.17 / $16,595.87
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $19,498.45 / $50,118.72
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $17,782.79 / $23,442.29
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $15,488.17 / $16,595.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $4,265.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $17,378.01