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
NM DOSE SM-153 LEXIDRONAM UP TO 150 MCI
Rapids, MN
See all hospitals reporting HCPCS A9604 →Price type
Allina Health Systems’s median price of $8.0k is 4% below the median hospital's median price ($8.4k), higher than 48% of the 1,374 hospitals reporting HCPCS A9604. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 27 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Bcbs Mn bc pmap (amu) facility · other · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 2 | Aetna allina aetna medicare (m) facility · fee schedule · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 3 | Medicare medicare (m) facility · fee schedule · outpatient | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 4 | Bcbs Mn bc state health plan (mu) facility · other · outpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 5 | Medica medica medicare (m) facility · fee schedule · outpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 6 | Blue Cross Blue Shield bc medicare (m) facility · fee schedule · outpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 7 | Bcbs Mn bc premier (m u) facility · other · outpatient | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 8 | Blue Cross Blue Shield bc aehp (mu) facility · other · outpatient | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 9 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 10 | Bcbs Mn bc high value/performance network (mu) facility · other · outpatient | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 11 | Medica medica pmap (um) facility · percent of total billed charges · outpatientfrom % of charges | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 12 | Medicaid medicaid ma (m) facility · fee schedule · outpatient | $7.0k | $7.0k | — | — | — | $7.0k – $7.0k |
| 13 | Aetna aetna elevate (amu) facility · percent of total billed charges · outpatientfrom % of charges | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 14 | Aetna aetna performance (amu) facility · percent of total billed charges · outpatientfrom % of charges | $8.1k | $8.1k | — | — | — | $8.1k – $8.1k |
| 15 | UnitedHealthcare uhc ubh pmap (m) facility · other · outpatient | $8.8k | $8.8k | — | — | — | $8.8k – $8.8k |
| 16 | Medica medica dual solutions (m) facility · percent of total billed charges · outpatientfrom % of charges | $9.6k | $9.6k | — | — | — | $9.6k – $9.6k |
| 17 | UnitedHealthcare united healthcare (um) facility · percent of total billed charges · outpatientfrom % of charges | $10.9k | $10.9k | — | — | — | $10.9k – $10.9k |
| 18 | Aetna aetna direct network (amu) facility · percent of total billed charges · outpatientfrom % of charges | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 19 | Bcbs Mn bc aware/blue plus (a m u) facility · percent of total billed charges · outpatientfrom % of charges | $12.8k | $12.8k | — | — | — | $12.8k – $12.8k |
| 20 | Medica medica elect (u m) facility · percent of total billed charges · outpatientfrom % of charges | $15.6k | $15.6k | — | — | — | $15.6k – $15.6k |
| 21 | Medica medica essentials (u m) facility · percent of total billed charges · outpatientfrom % of charges | $16.3k | $16.3k | — | — | — | $16.3k – $16.3k |
| 22 | Medica medica mhps (u m) facility · percent of total billed charges · outpatientfrom % of charges | $16.3k | $16.3k | — | — | — | $16.3k – $16.3k |
| 23 | Medica medica choice (u m) facility · percent of total billed charges · outpatientfrom % of charges | $17.1k | $17.1k | — | — | — | $17.1k – $17.1k |
| 24 | Medica medica ubh pmap (m) facility · percent of total billed charges · outpatientfrom % of charges | $17.4k | $17.4k | — | — | — | $17.4k – $17.4k |
| 25 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $18.2k | $18.2k | — | — | — | $18.2k – $18.2k |
Last updated: Jun 17, 2026
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