Diagnostic gallium-68 gozetotide (Illuccix) imaging agent at Mercy Hospital Fort Smith

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.

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Provider: anthropic
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Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Gallium Ga-68 Gozetotide Dx Illuccix 1 Mci

Smith, AR

See all hospitals reporting HCPCS A9596 →

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How this price compares nationally

Mercy Hospital Fort Smith’s median price of $484 is 54% below the median hospital's median price ($1.1k), higher than 7% of the 1,316 hospitals reporting HCPCS A9596. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9596 at Mercy Hospital Fort Smith

Negotiated rates from the hospital’s own file: 16 payers, 27 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	Aetna hb ftsm managed medicare facility · other · outpatient	$469	$469	—	—	—	$469 – $469
2	Blue Cross Blue Shield hb ftsm managed medicare facility · other · outpatient	$469	$469	—	—	—	$469 – $469
3	First Health hb ftsm managed medicare facility · other · outpatient	$469	$469	—	—	—	$469 – $469
4	Humana hb ftsm humana mcr facility · other · outpatient	$469	$469	—	—	—	$469 – $469
5	Medica hb ftsm managed medicare facility · other · outpatient	$469	$469	—	—	—	$469 – $469
6	Medicare hb ftsm medicare facility · other · outpatient	$469	$469	—	—	—	$469 – $469
7	Tricare hb ftsm tricare facility · other · outpatient	$469	$469	—	—	1–10	$469 – $469
8	UnitedHealthcare hb ftsm managed medicare facility · other · outpatient	$469	$469	—	—	—	$469 – $469
9	UnitedHealthcare hb ftsm uhc mcr 100% facility · other · outpatient	$469	$469	—	—	46	$469 – $469
10	Optum hb ftsm,wldar,ozkar,prsar,bnvr uhc facility · fee schedule · outpatient	$479	$479	—	—	—	$479 – $479
11	UnitedHealthcare hb ftsm,wldar,ozkar,prsar,bnvr uhc facility · fee schedule · outpatient	$479	$479	—	—	—	$479 – $479
12	WellCare hb ftsm novasys mcr 103% facility · other · outpatient	$484	$484	—	—	—	$484 – $484
13	Devoted hb ftsm devoted health mcr facility · other · outpatient	$489	$489	—	—	—	$489 – $489
14	Cigna hb ftsm healthspring cigna mcr 105% facility · other · outpatient	$493	$493	—	—	—	$493 – $493
15	Cigna hb ftsm cigna facility · percent of total billed charges · outpatientfrom % of charges	$563	$563	—	—	—	$563 – $563
16	Ambetter hb ftsm novasys ambetter exchange facility · other · outpatient	$670	$670	—	—	—	$670 – $670
17	First Health hb ftsm first health_ccn facility · percent of total billed charges · outpatientfrom % of charges	$870	$870	—	—	—	$870 – $870
18	Aetna hb ftsm coventry/aetna facility · percent of total billed charges · outpatientfrom % of charges	$900	$900	—	—	—	$900 – $900
19	Humana hb ftsm humana facility · percent of total billed charges · outpatientfrom % of charges	$900	$900	—	—	—	$900 – $900
20	Medicaid hb ftsm mo medicaid facility · fee schedule · outpatient	$934	$934	—	—	—	$934 – $934
21	MultiPlan hb ftsm,wldar,ozkar,prsar multi plan facility · percent of total billed charges · outpatientfrom % of charges	$956	$956	—	—	—	$956 – $956
22	Aetna hb ftsm ok managed medicaid facility · fee schedule · outpatient	$993	$993	—	—	—	$993 – $993
23	Humana hb ftsm ok managed medicaid facility · fee schedule · outpatient	$993	$993	—	—	—	$993 – $993
24	Medicaid hb ftsm ok medicaid facility · fee schedule · outpatient	$993	$993	—	—	—	$993 – $993
25	Anthem hb ftsm blue cross facility · fee schedule · outpatient	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k

Page 1 of 2 · 27 rates

Last updated: Jun 8, 2026

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