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
I-123 NA IO DX 200UCI/CAP
Los Angeles, CA
See all hospitals reporting HCPCS A9516 →Price type
Dignity Community Care’s median price of $125 is 30% below the median hospital's median price ($178), higher than 28% 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: 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.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Anthem medicaid|all plans fee schedule · outpatient | $112 | $112 | — | — | — | $112 – $112 |
| 2 | Anthem commercial|exchange fee schedule · outpatient | $125 | $125 | $18 | 14% | — | $107 – $143 |
| 3 | Molina medicaid|< 21 fee schedule · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 4 | Molina medicaid|> 21 fee schedule · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 5 | Kaiser medicaid|< 21 fee schedule · outpatient | $134 | $134 | — | — | — | $134 – $134 |
| 6 | Kaiser medicaid|> 21 fee schedule · outpatient | $134 | $134 | — | — | — | $134 – $134 |
| 7 | First Health commercial|all plans fee schedule · inpatient | $134 | $134 | $19 | 14% | — | $115 – $154 |
| 8 | First Health commercial|all plans fee schedule · outpatient | $134 | $134 | $19 | 14% | — | $115 – $154 |
| 9 | Kaiser commercial|all plans fee schedule · inpatient | $136 | $136 | $20 | 14% | — | $117 – $156 |
| 10 | Kaiser commercial|all plans fee schedule · outpatient | $136 | $136 | $20 | 14% | — | $117 – $156 |
| 11 | Blue Cross Blue Shield medicare|promise fee schedule · outpatient | $146 | $146 | $21 | 14% | — | $125 – $167 |
| 12 | MultiPlan commercial|all plans fee schedule · inpatient | $154 | $154 | $22 | 14% | — | $132 – $176 |
| 13 | MultiPlan commercial|all plans fee schedule · outpatient | $154 | $154 | $22 | 14% | — | $132 – $176 |
| 14 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $175 | $175 | $9 | 5% | — | $167 – $184 |
| 15 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $175 | $175 | $9 | 5% | — | $167 – $184 |
| 16 | Anthem commercial|all other plans fee schedule · outpatient | $187 | $187 | $27 | 14% | — | $160 – $214 |
| 17 | Anthem commercial|mcs fee schedule · outpatient | $195 | $195 | $28 | 14% | — | $167 – $223 |
| 18 | Blue Cross Blue Shield medicaid|all plans fee schedule · outpatient | $447 | $447 | — | — | — | $447 – $447 |
Last updated: Feb 28, 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.