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
I-123 SI CAPSULE 100 UCI
Valhalla, NY
See all hospitals reporting HCPCS A9516 →Price type
Westchester Medical Center’s median price of $121 is 32% below the median hospital's median price ($178), higher than 26% of the 1,910 hospitals reporting HCPCS A9516. 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 cross access facility · percent of total billed charges · outpatientfrom % of charges | $67 | $67 | — | — | — | $67 – $67 |
| 2 | Blue Cross Blue Shield blue cross commercial/healthy ny facility · percent of total billed charges · outpatientfrom % of charges | $67 | $67 | — | — | — | $67 – $67 |
| 3 | Blue Cross Blue Shield blue cross connection/exchange facility · percent of total billed charges · outpatientfrom % of charges | $67 | $67 | — | — | — | $67 – $67 |
| 4 | Blue Cross Blue Shield blue cross small group facility · percent of total billed charges · outpatientfrom % of charges | $67 | $67 | — | — | — | $67 – $67 |
| 5 | UnitedHealthcare uhc commercial facility · percent of total billed charges · outpatientfrom % of charges | $69 | $69 | — | — | — | $69 – $69 |
| 6 | UnitedHealthcare uhc compass facility · percent of total billed charges · outpatientfrom % of charges | $69 | $69 | — | — | — | $69 – $69 |
| 7 | UnitedHealthcare uhc empire facility · percent of total billed charges · outpatientfrom % of charges | $69 | $69 | — | — | — | $69 – $69 |
| 8 | UnitedHealthcare uhc exchange facility · percent of total billed charges · outpatientfrom % of charges | $69 | $69 | — | — | — | $69 – $69 |
| 9 | Aetna aetna hp network facility · percent of total billed charges · outpatientfrom % of charges | $116 | $116 | — | — | — | $116 – $116 |
| 10 | Aetna aetna facility · percent of total billed charges · outpatientfrom % of charges | $128 | $128 | — | — | — | $128 – $128 |
| 11 | Aetna aetna employee facility · percent of total billed charges · outpatientfrom % of charges | $128 | $128 | — | — | — | $128 – $128 |
| 12 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $138 | $138 | — | — | — | $138 – $138 |
| 13 | MultiPlan multiplan facility · percent of total billed charges · inpatientfrom % of charges | $138 | $138 | — | — | — | $138 – $138 |
| 14 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $148 | $148 | — | — | — | $148 – $148 |
| 15 | Phcs phcs facility · percent of total billed charges · inpatientfrom % of charges | $167 | $167 | — | — | — | $167 – $167 |
| 16 | Phcs phcs facility · percent of total billed charges · outpatientfrom % of charges | $167 | $167 | — | — | — | $167 – $167 |
| 17 | Tricare tricare facility · fee schedule · outpatient | $197 | $197 | — | — | — | $197 – $197 |
Last updated: Jul 28, 2026
See Iodine-123 diagnostic dose, 100-999 microcuries pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.