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Utah rates for HCPCS A9604

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

Facilitymedian $16,218 · 10th–90th $8,318–$33,1130%50%10th90th$16,218Professionalmedian $16,218 · 10th–90th $15,488–$19,4980%50%10th90th$16,218$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $19,498.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $14,125.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,918.31 / $10,232.93 / $46,773.51
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18,620.87 / $18,620.87 / $24,547.09
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $18,620.87 / $22,387.21
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,964.78 / $10,964.78 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10