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Washington rates for HCPCS A9604

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

Facilitymedian $16,596 · 10th–90th $3,388$54,9540%10%10th90th$16,596Professionalmedian $16,596 · 10th–90th $10,233$18,6210%50%10th90th$16,596$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
$16,595.87 / $16,595.87 / $39,810.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $16,595.87 / $19,498.45
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $25,703.96 / $53,703.18
Asuris Northwest Health
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 / $31,622.78 / $33,113.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,888.44 / $9,772.37 / $77,624.71
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,888.44 / $8,709.64 / $11,481.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $75.86
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $18,620.87 / $47,863.01
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18,620.87 / $18,620.87 / $18,620.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $22,387.21 / $53,703.18
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18,620.87 / $18,620.87 / $19,498.45
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
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18,620.87 / $23,988.33 / $26,302.68