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Pennsylvania rates for HCPCS A9607

Lutetium Lu 177 vipivotide tetraxetan, therapeutic, 1 mCi

Facilitymedian $631 · 10th–90th $251–$120,2260%10%10th90th$631Professionalmedian $251 · 10th–90th $240–$2950%20%40%10th90th$251$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
$251.19 / $630.96 / $120,226.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $245.47 / $295.12
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $288.40 / $363.08
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $912.01 / $977.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $524.81 / $831.76
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $389.05 / $645.65
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $245.47 / $295.12
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $257.04 / $288.40