HCPCS A9604
Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
Current code35 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 | $9,884 – $14,644 | $15,056 | $37,640 |
| Deaconess Medical Center | $9,044 – $9,576 | $47,621 | $119,053 |
| Harborview Medical Center | — | — | — |
| Highline Medical Center | — | $6,749 | $22,102 |
| Island Hospital | $9,332 – $10,124 | — | — |
| Kadlec Regional Medical Center | — | — | — |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | $9,354 – $10,102 | $25,860 | $64,651 |
| MultiCare Auburn Medical Center | $9,185 – $9,920 | $25,860 | $64,651 |
| MultiCare Covington Medical Center | $9,185 – $9,920 | $25,860 | $64,651 |
| MultiCare Good Samaritan Hospital | $9,397 – $10,149 | $25,860 | $64,651 |
| MultiCare Valley Hospital | $8,980 – $9,508 | $47,621 | $119,053 |
| Olympic Medical Center | $11,560 – $12,661 | — | — |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | — | — |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | — | — |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Mary Medical Center | — | — | — |
| Providence St Peter Hospital | — | — | — |
| St Anthony Hospital | — | $6,722 | $22,102 |
| St Clare Hospital | — | $6,371 | $22,102 |
| St Elizabeth Hospital | $3,757 – $4,575 | $7,810 | $22,102 |
| St Francis Community Hospital | — | $6,936 | $22,102 |
| St Joseph Medical Center | — | $7,320 | $22,102 |
| St Michael Medical Center | — | $9,755 | $22,102 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | — | — |
| Swedish Medical Center | — | — | — |
| Swedish Medical Center / Cherry Hill | — | — | — |
| Tacoma General Allenmore Hospital | $9,401 – $10,153 | $25,860 | $64,651 |
| University of Washington Medical Ctr | — | — | — |
| Virginia Mason Medical Center | — | $15,137 | $29,680 |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $8,983 – $10,437 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Hospital outpatient payment (national)
- $3,160 (APC 1295)
- Surgery center payment (national)
- $3,160