Iodine-123 diagnostic dose, 100-999 microcuries at UPMC Lititz

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

HC I123 CAP / 100UCI

Lititz, PA

See all hospitals reporting HCPCS A9516 →

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Pricing by billing methodology

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How this price compares nationally

UPMC Lititz’s median price of $109 is 39% below the median hospital's median price ($177), higher than 20% of the 1,889 hospitals reporting HCPCS A9516. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9516 at UPMC Lititz

Negotiated rates from the hospital’s own file: 5 payers, 12 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 medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$46	$46	—	—	—	$46 – $46
2	Aetna aco facility · percent of total billed charges · inpatientfrom % of charges	$87	$87	—	—	—	$87 – $87
3	Aetna aco facility · percent of total billed charges · outpatientfrom % of charges	$91	$91	—	—	—	$91 – $91
4	Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges	$103	$103	—	—	—	$103 – $103
5	Aetna medicare facility · fee schedule · outpatient	$108	$108	—	—	—	$108 – $108
6	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$109	$109	—	—	—	$109 – $109
7	Blue Cross Blue Shield chip facility · percent of total billed charges · outpatientfrom % of charges	$109	$109	—	—	—	$109 – $109
8	Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges	$109	$109	—	—	—	$109 – $109
9	Cigna commercial facility · fee schedule · outpatient	$138	$138	—	—	—	$138 – $138
10	UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges	$143	$143	—	—	—	$143 – $143
11	MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges	$197	$197	—	—	—	$197 – $197
12	MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges	$197	$197	—	—	—	$197 – $197

Last updated: Mar 6, 2026

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