Iodine-123 diagnostic dose, 100-999 microcuries

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

SODIUM IODIDE-123 < 1 MILLICURIE ORAL SOLUTION

Payers reporting HCPCS A9516

Payer pricing summary

Low

$53

Average

$921

Median

$350

High

$10.2k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +29 other terms	467	$200	$224	$176	78%	13–130	$1 – $2.3k
2	Anthem fee schedule · outpatient · +24 other terms	110	$119	$140	$137	98%	11–110	$34 – $1.8k
3	Blue Cross Blue Shield fee schedule · outpatient · +27 other terms	241	$346	$1.3k	$7.9k	584%	8–80	$1 – $67.5k
4	Healthpartners facility · other · outpatient · +10 other terms	4	$61	$61	—	—	4–40	$61 – $61
5	Medicare other · inpatient · +8 other terms	3	$81	$210	$139	66%	4–40	$61 – $348
6	Cigna fee schedule · outpatient · +19 other terms	261	$196	$1.6k	$9.3k	584%	2–20	$9 – $68.1k
7	Kaiser fee schedule · both · +18 other terms	47	$167	$172	$53	31%	2–20	$52 – $420
8	Medica fee schedule · outpatient · +17 other terms	28	$167	$204	$62	30%	2–20	$38 – $514
9	Bcbs Wy other · both · +3 other terms	1	$1.1k	$1.1k	—	—	1–10	$1.1k – $1.1k
10	Aetna fee schedule · outpatient · +29 other terms	132	$231	$324	$178	55%	—	$10 – $1.0k
11	Humana fee schedule · outpatient · +22 other terms	95	$432	$821	$770	94%	—	$38 – $2.1k
12	MultiPlan fee schedule · outpatient · +14 other terms	77	$281	$335	$208	62%	—	$45 – $915
13	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +3 other terms	58	$203	$254	$193	76%	—	$0 – $853
14	First Health fee schedule · inpatient · +15 other terms	31	$289	$258	$126	49%	—	$59 – $467
15	Molina fee schedule · outpatient · +22 other terms	30	$99	$116	$88	76%	—	$32 – $648
16	Highmark facility · fee schedule · outpatient · +14 other terms	22	$167	$324	$228	70%	—	$90 – $1.0k
17	Tricare facility · fee schedule · outpatient · +10 other terms	22	$334	$466	$636	136%	—	$2 – $3.1k
18	Medicaid fee schedule · outpatient · +8 other terms	20	$175	$375	$662	176%	—	$1 – $3.2k
19	Phcs fee schedule · outpatient · +10 other terms	20	$106	$386	$260	67%	—	$95 – $915
20	Bcbs Tx fee schedule · outpatient · +4 other terms	18	$780	$741	$217	29%	—	$121 – $1.2k
21	Caresource fee schedule · outpatient · +13 other terms	18	$165	$169	$119	70%	—	$26 – $439
22	Excellus facility · fee schedule · both · +9 other terms	17	$596	$815	$1.3k	154%	—	$71 – $7.6k
23	Carefirst facility · fee schedule · both · +7 other terms	16	$596	$882	$1.4k	155%	—	$71 – $7.6k
24	Premera facility · fee schedule · both · +8 other terms	16	$596	$882	$1.4k	155%	—	$71 – $7.6k
25	Regence facility · fee schedule · both · +12 other terms	16	$596	$865	$1.4k	159%	—	$71 – $7.6k

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