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New York rates for HCPCS A9604

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

Facilitymedian $13,490 · 10th–90th $3,162$17,7830%20%10th90th$13,490Professionalmedian $16,218 · 10th–90th $14,125$16,5960%50%10th90th$16,218$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
$13,489.63 / $15,488.17 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $16,218.10 / $16,595.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,311.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,595.87
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $17,782.79
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $25,118.86 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $28,840.32
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,762.47 / $7,762.47 / $7,762.47
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $4,265.80 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,125.38 / $16,595.87 / $17,378.01
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,762.47 / $7,762.47 / $7,762.47
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,762.47 / $7,762.47 / $7,762.47