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
ISO I-123 CAPSULE DX P100UCI
Arlington, TX
See all hospitals reporting HCPCS A9516 →Price type
AMH Cath Labs LLC’s median price of $151 is 15% below the median hospital's median price ($178), higher than 41% of the 1,896 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: 8 payers, 23 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 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $19 | $19 | — | — | — | $19 – $19 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $19 | $19 | — | — | — | $19 – $19 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $20 | $20 | — | — | — | $20 – $20 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $21 | $21 | — | — | — | $21 – $21 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $21 | $21 | — | — | — | $21 – $21 |
| 6 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $91 | $91 | — | — | — | $91 – $91 |
| 7 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $112 | $112 | — | — | — | $112 – $112 |
| 8 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $119 | $119 | — | — | — | $119 – $119 |
| 9 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $120 | $120 | — | — | — | $120 – $120 |
| 10 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $121 | $121 | — | — | — | $121 – $121 |
| 11 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $151 | $151 | — | — | — | $151 – $151 |
| 12 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $152 | $152 | — | — | — | $152 – $152 |
| 13 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $152 | $152 | — | — | — | $152 – $152 |
| 14 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $152 | $152 | — | — | — | $152 – $152 |
| 15 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $162 | $162 | — | — | — | $162 – $162 |
| 16 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $189 | $189 | — | — | — | $189 – $189 |
| 17 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $189 | $189 | — | — | — | $189 – $189 |
| 18 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $205 | $205 | — | — | — | $205 – $205 |
| 19 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $205 | $205 | — | — | — | $205 – $205 |
| 20 | Blue Cross Blue Shield hmo fee schedule · outpatient | $369 | $369 | — | — | — | $369 – $369 |
| 21 | Blue Cross Blue Shield exchange fee schedule · outpatient | $378 | $378 | — | — | — | $378 – $378 |
| 22 | Blue Cross Blue Shield ppo fee schedule · outpatient | $410 | $410 | — | — | — | $410 – $410 |
| 23 | Blue Cross Blue Shield traditional fee schedule · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
Last updated: Apr 21, 2026
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