Xenon-133 gas for diagnostic imaging

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

HC Xe133 Dx per 10mci

Payers reporting HCPCS A9558

Payer pricing summary

Low

$67

Average

$445

Median

$348

High

$1.7k

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +25 other terms	220	$432	$526	$394	75%	3–30	$1 – $2.5k
2	UnitedHealthcare fee schedule · outpatient · +23 other terms	396	$505	$533	$252	47%	1–10	$21 – $2.3k
3	Cigna fee schedule · outpatient · +19 other terms	212	$390	$674	$552	82%	—	$31 – $2.2k
4	Aetna fee schedule · outpatient · +23 other terms	104	$507	$567	$363	64%	—	$46 – $2.5k
5	Humana fee schedule · outpatient · +16 other terms	87	$298	$283	$185	65%	—	$67 – $704
6	Anthem fee schedule · outpatient · +20 other terms	59	$281	$281	$283	100%	—	$25 – $1.8k
7	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +2 other terms	47	$197	$280	$206	74%	—	$57 – $830
8	MultiPlan fee schedule · outpatient · +9 other terms	47	$366	$353	$189	54%	—	$62 – $720
9	Kaiser fee schedule · both · +15 other terms	46	$423	$429	$127	30%	—	$32 – $650
10	Medica fee schedule · outpatient · +14 other terms	24	$431	$446	$164	37%	—	$78 – $691
11	Bcbs Tx fee schedule · outpatient · +4 other terms	22	$1.0k	$916	$250	27%	—	$336 – $1.4k
12	Phcs fee schedule · outpatient · +8 other terms	19	$323	$316	$130	41%	—	$92 – $465
13	Molina facility · case rate · outpatient · +15 other terms	18	$124	$182	$205	113%	—	$82 – $1.2k
14	First Health fee schedule · inpatient · +13 other terms	17	$328	$382	$207	54%	—	$54 – $624
15	Caresource facility · case rate · outpatient · +11 other terms	15	$120	$125	$24	19%	—	$80 – $203
16	Excellus facility · fee schedule · both · +4 other terms	14	$76	$174	$154	88%	—	$43 – $663
17	Carefirst facility · fee schedule · both · +7 other terms	13	$68	$145	$165	114%	—	$43 – $663
18	Highmark facility · fee schedule · both · +13 other terms	13	$68	$145	$165	114%	—	$43 – $663
19	Premera facility · fee schedule · both · +6 other terms	13	$68	$145	$165	114%	—	$43 – $663
20	Regence facility · fee schedule · both · +12 other terms	13	$68	$146	$168	115%	—	$43 – $663
21	Wellmark fee schedule · both · +11 other terms	13	$255	$256	$6	2%	—	$255 – $292
22	Bcbs Mn fee schedule · outpatient · +8 other terms	12	$59	$38	$33	86%	—	$0 – $74
23	Bcbs Nj fee schedule · outpatient · +4 other terms	12	$254	$254	—	—	—	$254 – $254
24	WellCare professional · fee schedule · outpatient · +12 other terms	12	$283	$265	$68	26%	—	$42 – $302
25	Bcbs Az facility · fee schedule · outpatient · +1 other terms	11	$1.6k	$1.5k	$318	21%	—	$546 – $1.9k

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