HCPCS C9171
Injection, pegulicianine, 1 mg
Retired code21 hospitals with prices
This code is retired. Some hospitals still list it.
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Deaconess Medical Center | $167 | — | — |
| Legacy Salmon Creek Medical Center | $47.84 – $56.27 | — | — |
| Mary Bridge Children's Hospital | $295 | — | — |
| MultiCare Auburn Medical Center | $174 | — | — |
| MultiCare Covington Medical Center | $174 | — | — |
| MultiCare Good Samaritan Hospital | $174 | — | — |
| MultiCare Valley Hospital | $167 | — | — |
| Overlake Hospital Medical Center & Clinics | $88.96 – $110 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $56.27 | — | — |
| Providence Centralia Hospital | $37.51 – $56.27 | — | — |
| Providence Holy Family Hospital | $56.27 | — | — |
| Providence St Mary Medical Center | $37.51 – $56.27 | — | — |
| Providence St Peter Hospital | $37.51 – $60.02 | — | — |
| Swedish Edmonds Hospital | $45.01 | — | — |
| Swedish Issaquah | $37.51 – $75.02 | — | — |
| Swedish Medical Center | $37.51 – $75.02 | — | — |
| Swedish Medical Center / Cherry Hill | $37.51 – $75.02 | — | — |
| Tacoma General Allenmore Hospital | $174 | — | — |
| University of Washington Medical Ctr | $57.02 – $60.02 | — | — |
| Virginia Mason Medical Center | $37.51 | — | — |
| Yakima Valley Memorial | $104 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.