APC 09054

Lutetium Lu 177 vipivotide tetraxetan cancer treatment

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Lutetium lu 177 vipivotid

Payers reporting APC 09054

Payer pricing summary

Low

$254

Average

$262

Median

$260

High

$270

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +1 other terms	86	$252	$254	$10	4%	—	$194 – $270
2	Caresource fee schedule · outpatient	20	$259	$262	$4	1%	—	$259 – $267
3	Blue Cross Blue Shield fee schedule · outpatient · +1 other terms	11	$259	$259	—	—	—	$259 – $259
4	Aetna fee schedule · outpatient · +1 other terms	5	$265	$263	$1	0%	—	$262 – $265
5	Clover fee schedule · outpatient	5	$259	$259	—	—	—	$259 – $259
6	Kaiser fee schedule · outpatient · +1 other terms	5	$267	$267	—	—	—	$267 – $267
7	Medicare fee schedule · outpatient · +1 other terms	5	$259	$259	—	—	—	$259 – $259
8	UnitedHealthcare fee schedule · outpatient · +1 other terms	5	$259	$259	—	—	—	$259 – $259
9	WellCare fee schedule · outpatient	5	$267	$267	—	—	—	$267 – $267
10	Carefirst facility · fee schedule · outpatient	3	$259	$259	—	—	—	$259 – $259
11	Tricare facility · fee schedule · outpatient	3	$259	$259	—	—	—	$259 – $259
12	Medica facility · fee schedule · outpatient	1	$270	$270	—	—	—	$270 – $270