Lutetium-177 dotatate radiopharmaceutical, 1 millicurie

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-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLUTION

Payers reporting HCPCS A9513

Payer pricing summary

Low

$72

Average

$18.5k

Median

$7.1k

High

$156.6k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Cigna fee schedule · outpatient · +20 other terms	284	$449	$3.3k	$12.5k	375%	2–20	$254 – $70.3k
2	UnitedHealthcare fee schedule · outpatient · +22 other terms	577	$505	$2.1k	$14.5k	700%	1–10	$0 – $232.8k
3	Molina fee schedule · outpatient · +17 other terms	105	$341	$1.3k	$6.6k	498%	1–10	$1 – $53.4k
4	Optum fee schedule · outpatient · +12 other terms	41	$311	$392	$175	45%	1–10	$214 – $921
5	Aetna fee schedule · outpatient · +21 other terms	375	$327	$3.2k	$15.7k	491%	—	$1 – $158.6k
6	Blue Cross Blue Shield fee schedule · outpatient · +22 other terms	300	$506	$3.1k	$20.1k	654%	—	$1 – $225.6k
7	Humana fee schedule · outpatient · +19 other terms	243	$317	$2.5k	$13.4k	544%	—	$1 – $144.9k
8	WellCare fee schedule · outpatient · +11 other terms	130	$321	$343	$91	27%	—	$278 – $694
9	Anthem facility · fee schedule · outpatient · +19 other terms	103	$322	$2.1k	$11.2k	536%	—	$289 – $94.7k
10	Devoted fee schedule · outpatient · +8 other terms	66	$317	$313	$15	5%	—	$289 – $368
11	Kaiser fee schedule · outpatient · +11 other terms	61	$330	$538	$362	67%	—	$256 – $2.2k
12	Caresource fee schedule · outpatient · +8 other terms	55	$352	$576	$2.3k	404%	—	$1 – $27.9k
13	Ambetter facility · fee schedule · outpatient · +11 other terms	51	$558	$588	$130	22%	—	$296 – $767
14	MultiPlan fee schedule · outpatient · +13 other terms	43	$773	$39.8k	$77.2k	194%	—	$313 – $232.8k
15	Oscar facility · fee schedule · outpatient · +12 other terms	36	$481	$469	$73	16%	—	$359 – $586
16	Medica fee schedule · outpatient · +16 other terms	32	$10.0k	$20.3k	$56.2k	277%	—	$317 – $228k
17	Bcbs Tx fee schedule · outpatient · +3 other terms	31	$941	$872	$376	43%	—	$278 – $1.7k
18	Highmark facility · fee schedule · outpatient · +9 other terms	31	$469	$506	$283	56%	—	$135 – $1.4k
19	Clover fee schedule · outpatient · +4 other terms	29	$324	$324	$15	5%	—	$300 – $354
20	Medicare fee schedule · outpatient · +8 other terms	28	$311	$298	$6	2%	—	$275 – $321
21	Regence facility · fee schedule · outpatient · +8 other terms	21	$334	$373	$117	31%	—	$269 – $705
22	Medical Mutual facility · fee schedule · outpatient · +6 other terms	19	$527	$615	$280	46%	—	$174 – $1.3k
23	Wellmark fee schedule · outpatient · +7 other terms	18	$299	$296	$7	2%	—	$279 – $299
24	Aetna Better Health fee schedule · outpatient · +12 other terms	16	$317	$306	$21	7%	—	$276 – $328
25	Tricare fee schedule · outpatient · +10 other terms	16	$301	$662	$392	59%	—	$282 – $1.1k

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