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
I123 SOD DX 100-999 UCI
CONROE, TX
See all hospitals reporting HCPCS A9516 →Price type
Hca Houston Healthcare Conroe’s median price of $507 is 184% above the median hospital's median price ($178), higher than 90% 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: 11 payers, 40 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges | $95 | $95 | — | — | — | $95 – $95 |
| 2 | Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges | $95 | $95 | — | — | — | $95 – $95 |
| 3 | Superior Healthplan star percent of total billed charges · outpatientfrom % of charges | $95 | $95 | — | — | — | $95 – $95 |
| 4 | Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges | $95 | $95 | — | — | — | $95 – $95 |
| 5 | Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges | $95 | $95 | — | — | — | $95 – $95 |
| 6 | Aetna mcr percent of total billed charges · outpatientfrom % of charges | $105 | $105 | — | — | — | $105 – $105 |
| 7 | UnitedHealthcare allpayerappendix fee schedule · outpatient | $200 | $200 | — | — | — | $200 – $200 |
| 8 | UnitedHealthcare narrownetworkindivexchange fee schedule · outpatient | $200 | $200 | — | — | — | $200 – $200 |
| 9 | UnitedHealthcare smallgroup fee schedule · outpatient | $200 | $200 | — | — | — | $200 – $200 |
| 10 | Cigna csn fee schedule · outpatient | $262 | $262 | — | — | — | $262 – $262 |
| 11 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $278 | $278 | — | — | — | $278 – $278 |
| 12 | Cigna openaccessplus fee schedule · outpatient | $284 | $284 | — | — | — | $284 – $284 |
| 13 | Oscar hix percent of total billed charges · outpatientfrom % of charges | $308 | $308 | — | — | — | $308 – $308 |
| 14 | Cigna ppo fee schedule · outpatient | $338 | $338 | — | — | — | $338 – $338 |
| 15 | Blue Cross Blue Shield mybluehealth fee schedule · outpatient | $353 | $353 | — | — | — | $353 – $353 |
| 16 | Blue Cross Blue Shield bav fee schedule · outpatient | $389 | $389 | — | — | — | $389 – $389 |
| 17 | Healthcare Highways narrownetwork percent of total billed charges · outpatientfrom % of charges | $403 | $403 | — | — | — | $403 – $403 |
| 18 | Molina hix percent of total billed charges · outpatientfrom % of charges | $427 | $427 | — | — | — | $427 – $427 |
| 19 | Blue Cross Blue Shield eposoa fee schedule · outpatient | $486 | $486 | — | — | — | $486 – $486 |
| 20 | Blue Cross Blue Shield hmo fee schedule · outpatient | $486 | $486 | — | — | — | $486 – $486 |
| 21 | Blue Cross Blue Shield ppo fee schedule · outpatient | $486 | $486 | — | — | — | $486 – $486 |
| 22 | Aetna nbhmo percent of total billed charges · outpatientfrom % of charges | $507 | $507 | — | — | — | $507 – $507 |
| 23 | Aetna nbpos percent of total billed charges · outpatientfrom % of charges | $507 | $507 | — | — | — | $507 – $507 |
| 24 | Aetna nbppo percent of total billed charges · outpatientfrom % of charges | $507 | $507 | — | — | — | $507 – $507 |
| 25 | Aetna commhmo percent of total billed charges · outpatientfrom % of charges | $541 | $541 | — | — | — | $541 – $541 |
Last updated: May 14, 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.