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South Dakota rates for HCPCS A9604

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

Facilitymedian $4,266 · 10th–90th $4,266–$19,4980%50%90th$4,266Professionalmedian $16,596 · 10th–90th $4,169–$19,4980%20%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
$19,498.45 / $19,498.45 / $19,498.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $16,595.87 / $19,498.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $5,248.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $25,118.86 / $47,863.01
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,803.84 / $16,218.10 / $18,620.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,025.60 / $6,025.60 / $6,025.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13,803.84 / $16,218.10 / $18,620.87
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80