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.
Original text from hospital filings
Sm 153 lexidronam
Low
$28
Average
$9.2k
Median
$4.7k
High
$75.0k
Each hospital's average Amerihealth Caritas rate, under the methodology and billing class chosen below.
47 hospitals; the 90th percentile is 6.5× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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48 hospital rates
iThe hospitals that file a Amerihealth Caritas rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $9.3k | $9.3k | — | — | — | $9.3k – $9.3k |
| 2 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $9.3k | $9.3k | — | — | — | $9.3k – $9.3k |
| 3 | Fairfield Medical Center 401 N Ewing St facility · fee schedule · outpatient | 1 | $6.3k | $6.3k | — | — | — | $6.3k – $6.3k |
| 4 | HCA FLORIDA KENDALL HOSPITAL MIAMI, FL percent of total billed charges · outpatientfrom % of charges | 1 | $5.3k | $5.3k | — | — | — | $5.3k – $5.3k |
| 5 | HCA FLORIDA MERCY HOSPITAL MIAMI, FL percent of total billed charges · outpatientfrom % of charges | 1 | $25.1k | $25.1k | — | — | — | $25.1k – $25.1k |
| 6 | HCA FLORIDA NORTHWEST HOSPITAL MARGATE, FL percent of total billed charges · outpatientfrom % of charges | 1 | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
| 7 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 1 | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 8 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 1 | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 9 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 1 | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 10 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 1 | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 11 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $75.0k | $75.0k | — | — | — | $75.0k – $75.0k |
| 12 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $63.6k | $63.6k | — | — | — | $63.6k – $63.6k |
| 13 | Independence Health System Frick Hospital Mt Plesant, PA fee schedule · both | 1 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 14 | Independence Health System Latrobe Area Hospital Latrobe, PA fee schedule · both | 1 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 15 | Independence Health System Westmoreland Regional Hospital Greeensburg, PA fee schedule · both | 1 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 16 | Lenoir Memorial Hospital Kinston, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 17 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $5.2k | $5.2k | — | — | — | $5.2k – $5.2k |
| 18 | Mary Hitchcock Memorial Hospital Lebanon, NH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 19 | Memorial Hospital Miramar Miramar, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 20 | Memorial Hospital Pembroke Pembroke Pines, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 21 | Memorial Hospital West Pembroke Pines, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 22 | Memorial Regional Hospital Hollywood, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 23 | Rex Hospital, Inc. Holly Springs, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 24 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $16.9k | $16.9k | — | — | — | $16.9k – $16.9k |
| 25 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $17.2k | $17.2k | — | — | — | $17.2k – $17.2k |
← Payers reporting HCPCS A9604 · Snapshot 20261111T120946Z-9134e7f7