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 I 123 DIAG CAP PER 100 UCI UP TO 999 UCI
River Falls, WI
See all hospitals reporting HCPCS A9516 →Price type
Allina Health Systems’s median price of $69 is 61% below the median hospital's median price ($178), higher than 7% of the 1,920 hospitals reporting HCPCS A9516. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 18 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $18 | $18 | — | — | — | $18 – $18 |
| 2 | Medica medica pmap (r) facility · percent of total billed charges · outpatientfrom % of charges | $24 | $24 | — | — | — | $24 – $24 |
| 3 | Blue Cross Blue Shield bc medicare (r) facility · fee schedule · outpatient | $40 | $40 | — | — | — | $40 – $40 |
| 4 | Medica medica medicare (r) facility · fee schedule · outpatient | $40 | $40 | — | — | — | $40 – $40 |
| 5 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $41 | $41 | — | — | — | $41 – $41 |
| 6 | UnitedHealthcare united healthcare (nr) facility · percent of total billed charges · outpatientfrom % of charges | $45 | $45 | — | — | — | $45 – $45 |
| 7 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $55 | $55 | — | — | — | $55 – $55 |
| 8 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $56 | $56 | — | — | — | $56 – $56 |
| 9 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $60 | $60 | — | — | — | $60 – $60 |
| 10 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $60 | $60 | — | — | — | $60 – $60 |
| 11 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $76 | $76 | — | — | — | $76 – $76 |
| 12 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $76 | $76 | — | — | — | $76 – $76 |
| 13 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $76 | $76 | — | — | — | $76 – $76 |
| 14 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $77 | $77 | — | — | — | $77 – $77 |
| 15 | Bcbs Mn bc pmap (r) facility · fee schedule · outpatient | $312 | $312 | — | — | — | $312 – $312 |
| 16 | Bcbs Mn bc state health plan (r) facility · fee schedule · outpatient | $840 | $840 | — | — | — | $840 – $840 |
| 17 | Bcbs Mn bc premier (r) facility · fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 18 | Blue Cross Blue Shield bc aehp (r) facility · fee schedule · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
Last updated: Jun 15, 2026
See Iodine-123 diagnostic dose, 100-999 microcuries pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.