Xenon-133 gas for diagnostic imaging at Samaritan Hospital

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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Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

XE-133 XENON GAS PER 10 MCI

Troy, NY

See all hospitals reporting HCPCS A9558 →

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Pricing by billing methodology

Price type

How this price compares nationally

Samaritan Hospital’s median price of $155 is 50% below the median hospital's median price ($309), higher than 18% of the 1,455 hospitals reporting HCPCS A9558. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9558 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 14 payers, 22 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 uhc essential plan medicaid facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
2	UnitedHealthcare united healthcare medicaid harp chip facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
3	Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
4	Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
5	Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
6	Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
7	Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
8	Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
9	Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
10	Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
11	Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
12	Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
13	Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
14	Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$155	$155	—	—	—	$155 – $155
15	Aetna aetna facility · percent of total billed charges · bothfrom % of charges	$197	$197	—	—	—	$197 – $197
16	Medical Mutual aetna facility · percent of total billed charges · bothfrom % of charges	$197	$197	—	—	—	$197 – $197
17	First Health first health facility · percent of total billed charges · bothfrom % of charges	$225	$225	—	—	—	$225 – $225
18	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$239	$239	—	—	—	$239 – $239
19	MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges	$253	$253	—	—	—	$253 – $253
20	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$253	$253	—	—	—	$253 – $253
21	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$253	$253	—	—	—	$253 – $253
22	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$281	$281	—	—	—	$281 – $281

Last updated: Mar 31, 2026

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