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
XENON XE-133 DX PER 10MCI
Phoenix, AZ
See all hospitals reporting HCPCS A9558 →Price type
Dignity Health’s median price of $328 is 6% above the median hospital's median price ($309), higher than 53% 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: 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 commercial|dignityhealthemployee fee schedule · outpatient | $89 | $89 | — | — | — | $89 – $89 |
| 2 | Aetna commercial|all plans fee schedule · outpatient | $100 | $100 | — | — | — | $100 – $100 |
| 3 | Optum commercial|optumhealth fee schedule · outpatient | $220 | $220 | — | — | — | $220 – $220 |
| 4 | Cigna commercial|lifesource fee schedule · outpatient | $257 | $257 | — | — | — | $257 – $257 |
| 5 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $261 | $261 | — | — | — | $261 – $261 |
| 6 | Cigna commercial|exchange fee schedule · outpatient | $323 | $323 | — | — | — | $323 – $323 |
| 7 | First Health commercial|all plans fee schedule · inpatient | $328 | $328 | — | — | — | $328 – $328 |
| 8 | First Health commercial|all plans fee schedule · outpatient | $328 | $328 | — | — | — | $328 – $328 |
| 9 | Cigna commercial|localplus surefit fee schedule · outpatient | $346 | $346 | — | — | — | $346 – $346 |
| 10 | MultiPlan commercial|all plans fee schedule · inpatient | $370 | $370 | — | — | — | $370 – $370 |
| 11 | MultiPlan commercial|all plans fee schedule · outpatient | $370 | $370 | — | — | — | $370 – $370 |
| 12 | Cigna commercial|all other plans fee schedule · outpatient | $455 | $455 | — | — | — | $455 – $455 |
| 13 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $468 | $468 | — | — | — | $468 – $468 |
| 14 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $468 | $468 | — | — | — | $468 – $468 |
| 15 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $468 | $468 | — | — | — | $468 – $468 |
| 16 | Blue Cross Blue Shield commercial|workers comp fee schedule · outpatient | $468 | $468 | — | — | — | $468 – $468 |
Last updated: Feb 28, 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.