Iodine-123 sodium iodide diagnostic dose, per millicurie at Allina Health Systems

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.

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Generated: October 20, 2026

Original text from hospital filings

NM DOSE I 123 DIAG PER MCI

Ulm, MN

See all hospitals reporting HCPCS A9509 →

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Pricing by billing methodology

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How this price compares nationally

Allina Health Systems’s median price of $437 is 6% above the median hospital's median price ($411), higher than 52% of the 1,323 hospitals reporting HCPCS A9509. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9509 at Allina Health Systems

Negotiated rates from the hospital’s own file: 9 payers, 24 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 (n) facility · other · outpatient	$72	$72	—	—	—	$72 – $72
2	Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges	$143	$143	—	—	—	$143 – $143
3	Bcbs Mn bc state health plan (n) facility · other · outpatient	$195	$195	—	—	—	$195 – $195
4	Medica medica pmap (n) facility · percent of total billed charges · outpatientfrom % of charges	$227	$227	—	—	—	$227 – $227
5	Bcbs Mn bc premier(n) facility · other · outpatient	$250	$250	—	—	—	$250 – $250
6	Blue Cross Blue Shield bc aehp (n) facility · other · outpatient	$295	$295	—	—	—	$295 – $295
7	Medicaid medicaid ma (n) facility · other · outpatient	$312	$312	—	—	—	$312 – $312
8	Bcbs Mn bc high value/performance network (n) facility · other · outpatient	$316	$316	—	—	—	$316 – $316
9	Medica medica medicare (r) facility · fee schedule · outpatient	$317	$317	—	—	—	$317 – $317
10	Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges	$321	$321	—	—	—	$321 – $321
11	Blue Cross Blue Shield bc medicare (n) facility · fee schedule · outpatient	$331	$331	—	—	—	$331 – $331
12	UnitedHealthcare united healthcare (nr) facility · percent of total billed charges · outpatientfrom % of charges	$356	$356	—	—	—	$356 – $356
13	Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges	$437	$437	—	—	—	$437 – $437
14	Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges	$441	$441	—	—	—	$441 – $441
15	Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges	$472	$472	—	—	—	$472 – $472
16	Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges	$476	$476	—	—	—	$476 – $476
17	Medica medica ubh (n) facility · percent of total billed charges · inpatientfrom % of charges	$499	$499	—	—	—	$499 – $499
18	Medica medica ubh pmap (n) facility · percent of total billed charges · outpatientfrom % of charges	$570	$570	—	—	—	$570 – $570
19	Cigna hpi cigna (n) facility · other · outpatient	$583	$583	—	—	—	$583 – $583
20	First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges	$599	$599	—	—	—	$599 – $599
21	First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges	$599	$599	—	—	—	$599 – $599
22	Medica medica ubh (n) facility · percent of total billed charges · outpatientfrom % of charges	$599	$599	—	—	—	$599 – $599
23	Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges	$603	$603	—	—	—	$603 – $603
24	Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges	$609	$609	—	—	—	$609 – $609

Last updated: Jun 16, 2026

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