A9607

Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie

Medicare pricing data for 196 providers across 21 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie (HCPCS code A9607) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $248.45, but hospitals typically charge $524.63 — a 2.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$49.69

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $248.45, your out-of-pocket cost would be approximately $49.69. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$248.45
Average Hospital Charge
$524.63
Markup Ratio
2.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$524.63
Medicare Allowed$248.45
Medicare Payment$197.94

Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $197.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Tennessee$321$50756,649+29.1%
Georgia$308$7441029,484+24.2%
Virginia$283$567831,464+14.1%
Maine$254$49619,002+2.3%
Texas$248$5111573,172-0.0%
Maryland$246$323450,826-1.2%
Colorado$245$563615,741-1.3%
Arkansas$245$5141722,809-1.4%
Washington$243$447930,112-2.0%
New Mexico$243$533210,317-2.2%
Nebraska$243$4421124,451-2.3%
Michigan$242$699628,608-2.4%
Louisiana$242$386411,120-2.6%
Arizona$241$4751456,105-3.0%
Idaho$240$50923,800-3.5%
California$240$318819,343-3.6%
Florida$238$7092595,446-4.2%
New York$237$39958,624-4.5%
Pennsylvania$236$409423,400-4.9%
New Jersey$231$485817,063-7.0%
Ohio$221$4281210,801-11.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber