HCPCS A9604 at Providence St Peter Hospital

Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries

Providence St Peter Hospital, Olympia

Description from CMS's HCPCS Level II code file.

What Providence St Peter Hospital publishes for this code: as an outpatient

Providence St Peter Hospital’s prices for HCPCS A9604, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$2,686 – $53,50613 plans	—
Medicare AdvantageInsurer rates	$3,160 – $5,0567 plans	—
Cash pricePaying yourself, without insurance	—	—
List priceBefore any discount; few people pay it	—	—

Lowest and highest amounts Providence St Peter Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-04-01. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS A9604 at Providence St Peter Hospital
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The service	—	The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS A9604 at every Washington hospital, with Medicare’s reference amounts.