C9457 Lumason contrast agent

Injection, sulfur hexafluoride lipid microsphere, per ml

Payer policies and prior authorization for C9457

Medicaid fee-for-service

  • WY: $0.00 (professional), effective Oct 1, 2015

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.