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
HC A9558 MED: XENON XE-133 GAS, DX, PER 10 MCI
Orange, TX
See all hospitals reporting HCPCS A9558 →Price type
CHRISTUS Hospital - Orange’s median price of $453 is 46% above the median hospital's median price ($309), higher than 67% of the 1,455 hospitals reporting HCPCS A9558. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 25 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 | Humana choicecare fee schedule · outpatient | $87 | $87 | — | — | — | $87 – $87 |
| 2 | UnitedHealthcare chip km percent of total billed charges · outpatientfrom % of charges | $118 | $127 | $16 | 12% | — | $114 – $149 |
| 3 | UnitedHealthcare star kid km percent of total billed charges · outpatientfrom % of charges | $118 | $127 | $16 | 12% | — | $114 – $149 |
| 4 | UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges | $118 | $127 | $16 | 12% | — | $114 – $149 |
| 5 | UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges | $118 | $127 | $16 | 12% | — | $114 – $149 |
| 6 | UnitedHealthcare all payer fee schedule · outpatient | $272 | $272 | — | — | — | $272 – $272 |
| 7 | UnitedHealthcare hix fee schedule · outpatient | $272 | $272 | — | — | — | $272 – $272 |
| 8 | Aetna mm percent of total billed charges · outpatientfrom % of charges | $283 | $305 | $38 | 12% | — | $275 – $358 |
| 9 | UnitedHealthcare hix percent of total billed charges · outpatientfrom % of charges | $330 | $356 | $44 | 12% | — | $320 – $418 |
| 10 | Molina chip km percent of total billed charges · outpatientfrom % of charges | $354 | $382 | $47 | 12% | — | $343 – $448 |
| 11 | Molina star km percent of total billed charges · outpatientfrom % of charges | $354 | $382 | $47 | 12% | — | $343 – $448 |
| 12 | Molina star plus km percent of total billed charges · outpatientfrom % of charges | $354 | $382 | $47 | 12% | — | $343 – $448 |
| 13 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $354 | $382 | $47 | 12% | — | $343 – $448 |
| 14 | Cigna new business percent of total billed charges · outpatientfrom % of charges | $460 | $496 | $61 | 12% | — | $446 – $582 |
| 15 | Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges | $531 | $572 | $70 | 12% | — | $515 – $671 |
| 16 | Devoted mm percent of total billed charges · outpatientfrom % of charges | $590 | $636 | $78 | 12% | — | $572 – $746 |
| 17 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $707 | $763 | $94 | 12% | — | $686 – $895 |
| 18 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $815 | $815 | — | — | — | $815 – $815 |
| 19 | First Health ppo percent of total billed charges · outpatientfrom % of charges | $766 | $827 | $102 | 12% | — | $744 – $970 |
| 20 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $825 | $890 | $110 | 12% | — | $801 – $1.0k |
| 21 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $825 | $890 | $110 | 12% | — | $801 – $1.0k |
| 22 | Bcbs Tx heb fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 23 | Bcbs Tx hmo fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 24 | Bcbs Tx ppo fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 25 | Bcbs Tx traditional fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
Last updated: Jan 13, 2026
See Xenon-133 gas for diagnostic imaging pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.