Iodine-123 sodium iodide diagnostic dose, per millicurie at St. David's Georgetown 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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

I123 SODIUM IOD DX 1 MCI

Georgetown, TX

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How this price compares nationally

St. David's Georgetown Hospital’s median price of $306 is 26% below the median hospital's median price ($412), higher than 42% of the 1,320 hospitals reporting HCPCS A9509. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9509 at St. David's Georgetown Hospital

Negotiated rates from the hospital’s own file: 9 payers, 36 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	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$45	$45	—	—	—	$45 – $45
2	Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges	$45	$45	—	—	—	$45 – $45
3	Superior Healthplan star percent of total billed charges · outpatientfrom % of charges	$45	$45	—	—	—	$45 – $45
4	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$45	$45	—	—	—	$45 – $45
5	Superior Healthplan ambetterepo percent of total billed charges · outpatientfrom % of charges	$152	$152	—	—	—	$152 – $152
6	Superior Healthplan ambetterhmo percent of total billed charges · outpatientfrom % of charges	$152	$152	—	—	—	$152 – $152
7	Superior Healthplan valuehmo percent of total billed charges · outpatientfrom % of charges	$152	$152	—	—	—	$152 – $152
8	Oscar hix percent of total billed charges · outpatientfrom % of charges	$172	$172	—	—	—	$172 – $172
9	Oscar hmo percent of total billed charges · outpatientfrom % of charges	$172	$172	—	—	—	$172 – $172
10	Oscar epo percent of total billed charges · outpatientfrom % of charges	$192	$192	—	—	—	$192 – $192
11	Oscar pos percent of total billed charges · outpatientfrom % of charges	$192	$192	—	—	—	$192 – $192
12	Oscar ppo percent of total billed charges · outpatientfrom % of charges	$192	$192	—	—	—	$192 – $192
13	UnitedHealthcare narrownetworkhix fee schedule · outpatient	$212	$212	—	—	—	$212 – $212
14	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$223	$223	—	—	—	$223 – $223
15	Humana hmo percent of total billed charges · outpatientfrom % of charges	$249	$249	—	—	—	$249 – $249
16	Humana ppo percent of total billed charges · outpatientfrom % of charges	$249	$249	—	—	—	$249 – $249
17	Healthcare Highways epo percent of total billed charges · outpatientfrom % of charges	$260	$260	—	—	—	$260 – $260
18	Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges	$269	$269	—	—	—	$269 – $269
19	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$286	$286	—	—	—	$286 – $286
20	UnitedHealthcare allpayerappendix fee schedule · outpatient	$287	$287	—	—	—	$287 – $287
21	UnitedHealthcare smallgroup fee schedule · outpatient	$287	$287	—	—	—	$287 – $287
22	Cigna newbusinessnetwork percent of total billed charges · outpatientfrom % of charges	$287	$287	—	—	—	$287 – $287
23	Cigna hmo percent of total billed charges · outpatientfrom % of charges	$306	$306	—	—	—	$306 – $306
24	Cigna openaccess percent of total billed charges · outpatientfrom % of charges	$306	$306	—	—	—	$306 – $306
25	Cigna openaccessplus percent of total billed charges · outpatientfrom % of charges	$306	$306	—	—	—	$306 – $306

Page 1 of 2 · 36 rates

Last updated: Sep 1, 2026

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