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New Hampshire rates for HCPCS A9604

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

Facilitymedian $16,596 · 10th–90th $4,898–$35,4810%10%10th90th$16,596Professionalmedian $16,596 · 10th–90th $15,488–$26,9150%50%10th90th$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
Facility
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $19,952.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,489.63 / $16,595.87 / $16,595.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $12,302.69 / $33,884.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,595.87 / $19,054.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,620.87 / $35,481.34 / $45,708.82
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 / $31,622.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,079.46 / $7,079.46 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,595.87