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Pennsylvania rates for HCPCS A9604

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

Facilitymedian $18,621 · 10th–90th $4,677$61,6600%20%40%10th90th$18,621Professionalmedian $16,596 · 10th–90th $15,488$16,5960%50%10th$16,596$1.0$10.0$100.0$1.0K$10.0K$100.0K

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 / $18,620.87 / $102,329.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $16,595.87 / $16,595.87
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,791.08 / $17,782.79 / $26,302.68
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18,620.87 / $18,620.87 / $18,620.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,595.87 / $57,543.99 / $61,659.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,182.57 / $13,182.57 / $13,182.57
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $16,595.87 / $16,595.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $20,417.38
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $20,417.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $19,498.45