HCPCS A9516
Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries
Current code28 hospitals with prices
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $24.00 – $27.60 | $60.00 – $69.00 |
| Cascade Valley Hospital | $282 | $226 | $282 |
| Deaconess Medical Center | — | $205 | $512 |
| EvergreenHealth Medical Center | — | $1,144 | $1,430 |
| Highline Medical Center | — | $59.55 – $238 | $195 – $780 |
| Mary Bridge Children's Hospital | — | $205 | $513 |
| MultiCare Auburn Medical Center | — | $205 | $513 |
| MultiCare Covington Medical Center | — | $205 | $513 |
| MultiCare Good Samaritan Hospital | — | $205 | $513 |
| MultiCare Valley Hospital | — | $205 | $512 |
| Overlake Hospital Medical Center & Clinics | — | $48.16 – $50.92 | $96.32 – $102 |
| Skagit Valley Hospital | $265 | $226 – $366 | $282 – $457 |
| St Anthony Hospital | — | $59.31 – $237 | $195 – $780 |
| St Clare Hospital | — | $56.21 – $225 | $195 – $780 |
| St Elizabeth Hospital | $54.60 – $259 | $68.91 – $276 | $195 – $780 |
| St Francis Community Hospital | — | $61.20 – $245 | $195 – $780 |
| St Joseph Medical Center | — | $64.59 – $258 | $195 – $780 |
| St Michael Medical Center | — | $86.07 – $344 | $195 – $780 |
| Tacoma General Allenmore Hospital | — | $203 – $205 | $508 – $513 |
| Virginia Mason Medical Center | — | $96.39 | $189 |
| Yakima Valley Memorial | — | $96.80 – $111 | $242 – $278 |
Medicare (traditional) reference
CMS publishes no national amount for this code.