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
SAMARIUM SM-153 LEXIDRONAM, THERAPEUTIC, PER TREATMENT DOSE, UP TO 150 MILLICURIES
Ukiah, CA
See all hospitals reporting HCPCS A9604 →Price type
Ukiah Adventist Hospital’s median price of $32.9k is 293% above the median hospital's median price ($8.4k), higher than 92% of the 1,379 hospitals reporting HCPCS A9604. 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, 17 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 | Blue Cross Blue Shield blue shield mcr adv other · outpatient | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 2 | Blue Cross Blue Shield tricare blue shield-all plans other · outpatient | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 3 | Kaiser kaiser mcr adv other · outpatient | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 4 | UnitedHealthcare uhc mcr adv other · outpatient | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 5 | UnitedHealthcare uhc all payer-all other plans fee schedule · outpatient | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
| 6 | Blue Cross Blue Shield blue shield epn-all other plans percent of total billed charges · outpatientfrom % of charges | $10.2k | $10.2k | — | — | — | $10.2k – $10.2k |
| 7 | Blue Cross Blue Shield blue shield non-epn percent of total billed charges · outpatientfrom % of charges | $10.3k | $10.3k | — | — | — | $10.3k – $10.3k |
| 8 | UnitedHealthcare uhc jll csp 1/1/25 fee schedule · outpatient | $11.7k | $11.7k | — | — | — | $11.7k – $11.7k |
| 9 | Kaiser kaiser medi-cal fee schedule · outpatient | $23.4k | $23.4k | — | — | — | $23.4k – $23.4k |
| 10 | Medicaid medi-cal fee schedule · outpatient | $23.4k | $23.4k | — | — | — | $23.4k – $23.4k |
| 11 | Blue Cross Blue Shield blue cross exchange fee schedule · outpatient | $28.0k | $28.0k | — | — | — | $28.0k – $28.0k |
| 12 | Blue Cross Blue Shield blue cross non-mcs fee schedule · outpatient | $31.1k | $31.1k | — | — | — | $31.1k – $31.1k |
| 13 | Blue Cross Blue Shield blue cross mcs-all other plans fee schedule · outpatient | $37.3k | $37.3k | — | — | — | $37.3k – $37.3k |
| 14 | Aetna aetna-all plans percent of total billed charges · outpatientfrom % of charges | $44.2k | $44.2k | — | — | — | $44.2k – $44.2k |
| 15 | Cigna cigna-all plans percent of total billed charges · outpatientfrom % of charges | $52.0k | $52.0k | — | — | — | $52.0k – $52.0k |
| 16 | Kaiser kaiser-all other plans percent of total billed charges · outpatientfrom % of charges | $53.3k | $53.3k | — | — | — | $53.3k – $53.3k |
| 17 | MultiPlan phcs multiplan-all plans percent of total billed charges · outpatientfrom % of charges | $53.3k | $53.3k | — | — | — | $53.3k – $53.3k |
Last updated: May 24, 2026
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