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 100UCI/CAP
Phoenix, AZ
See all hospitals reporting HCPCS A9516 →Price type
Dignity Health’s median price of $366 is 105% above the median hospital's median price ($178), higher than 82% of the 1,910 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, 16 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 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $98 | $98 | — | — | — | $98 – $98 |
| 2 | Aetna commercial|all plans fee schedule · outpatient | $100 | $100 | — | — | — | $100 – $100 |
| 3 | UnitedHealthcare commercial|dignityhealthemployee fee schedule · outpatient | $111 | $111 | — | — | — | $111 – $111 |
| 4 | Cigna commercial|exchange fee schedule · outpatient | $134 | $134 | — | — | — | $134 – $134 |
| 5 | Cigna commercial|localplus surefit fee schedule · outpatient | $144 | $144 | — | — | — | $144 – $144 |
| 6 | Cigna commercial|all other plans fee schedule · outpatient | $190 | $190 | — | — | — | $190 – $190 |
| 7 | Optum commercial|optumhealth fee schedule · outpatient | $276 | $276 | — | — | — | $276 – $276 |
| 8 | Cigna commercial|lifesource fee schedule · outpatient | $322 | $322 | — | — | — | $322 – $322 |
| 9 | First Health commercial|all plans fee schedule · inpatient | $410 | $410 | — | — | — | $410 – $410 |
| 10 | First Health commercial|all plans fee schedule · outpatient | $410 | $410 | — | — | — | $410 – $410 |
| 11 | MultiPlan commercial|all plans fee schedule · inpatient | $463 | $463 | — | — | — | $463 – $463 |
| 12 | MultiPlan commercial|all plans fee schedule · outpatient | $463 | $463 | — | — | — | $463 – $463 |
| 13 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $491 | $491 | — | — | — | $491 – $491 |
| 14 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $491 | $491 | — | — | 1–10 | $491 – $491 |
| 15 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $586 | $586 | — | — | 1–10 | $586 – $586 |
| 16 | Blue Cross Blue Shield commercial|workers comp fee schedule · outpatient | $586 | $586 | — | — | — | $586 – $586 |
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.