Understanding How much does Y-90 cost? A comprehensive guide to radioembolization expenses

October 5, 2025 •

4 min read

Based on institutional studies, the average price for a single Y-90 radioembolization procedure is around $32,500, though this figure can vary significantly based on patient and treatment specifics. Understanding how much does Y-90 cost involves evaluating multiple components beyond the initial treatment price, including diagnostics, physician fees, and insurance coverage.

Quick Summary

The total cost for Y-90 radioembolization is influenced by many variables, including microsphere type, treatment facility, and insurance. Expenses encompass the radioactive dose, preliminary testing, and professional fees. The number of required treatment sessions also significantly impacts the overall financial burden.

Key Points

Average Procedure Cost: A single Y-90 radioembolization procedure averages approximately $32,500, but the total cost varies based on many factors.
Major Cost Components: The total expense includes the radioactive microspheres (potentially over $18,000), pre-procedure mapping and imaging, and facility and professional fees.
Comparison to Alternatives: A single Y-90 treatment is more expensive than a single TACE procedure, but the overall cost can be lower with Y-90 due to fewer treatments and shorter hospital stays.
Insurance Coverage: Most major insurance plans, including Medicare, provide coverage for Y-90 radioembolization, especially for approved conditions like metastatic colorectal cancer in the liver.
Patient Responsibility: Patient out-of-pocket costs depend on their specific insurance plan's co-pays, deductibles, and co-insurance. Uninsured patients may face costs of $25,000 or more.
Outpatient vs. Inpatient: Performing Y-90 in an outpatient setting (OBL) can save on hospital admission costs, but it may present complex billing challenges with some insurers.
Pre-Authorization is Key: For insured patients, obtaining prior authorization before treatment is critical to ensuring coverage for the entire procedure and associated work-up.

Cost Components of Y-90 Radioembolization

Yttrium-90 (Y-90) radioembolization, a form of Selective Internal Radiation Therapy (SIRT), delivers targeted radiation to liver tumors. The total cost is a complex sum of several factors, not just the radioactive microspheres themselves. Understanding each component is key to navigating the financial landscape of this advanced cancer treatment.

Microsphere Device

This is often the largest single expense. The Y-90 microspheres are commercially available in two primary forms: glass and resin. The cost for the dose/spheres can be substantial, with recent reports indicating purchase costs for facilities ranging around $18,000 per case. The device cost varies depending on the manufacturer and the specific quantity needed for the patient's treatment plan.

Pre-Procedure Diagnostic Work-up

Before the therapeutic procedure, patients must undergo a mapping procedure (diagnostic angiogram) and other imaging to assess the liver's blood supply and the extent of the tumor. This stage ensures the radioactive microspheres will be safely and effectively delivered to the tumor. Costs for these preparatory tests, including imaging, angiography, and consultation fees, are all part of the total expense.

Professional and Facility Fees

The total bill includes charges for the healthcare professionals and the facility where the procedure is performed. This typically includes:

Interventional Radiologist's fee for performing the procedure.
Nuclear Medicine specialist's fees.
Anesthesia fees.
Hospital or Outpatient-Based Lab (OBL) fees for the use of the facility, equipment, and staff.

Y-90 Cost vs. Other Liver Cancer Treatments

While the upfront cost of a single Y-90 procedure can seem high, it's crucial to compare it to the overall cost of alternative treatments like Transarterial Chemoembolization (TACE) and Stereotactic Body Radiation Therapy (SBRT), especially since fewer Y-90 sessions may be required.

Comparison Table: Y-90 vs. TACE


Feature	Y-90 Radioembolization	Transarterial Chemoembolization (TACE)
Average Cost (per procedure)	$30,000 to $35,000	$18,000 to $22,000
Overall Cost (Multiple Procedures)	Lower potential total cost if fewer sessions are needed	Higher potential total cost due to more frequent sessions
Hospital Stay	Often outpatient (same-day discharge)	Often requires a hospital stay (e.g., one night)
Treatment Delivery	Internal radiation delivered via microspheres	Chemotherapy and embolic agents delivered directly to the tumor
Key Takeaway	Higher upfront cost per session, but potentially lower overall cost due to fewer required treatments and no overnight hospital stay.	Lower upfront cost per session, but potentially higher total cost due to multiple procedures and hospital admissions.

Cost-Effectiveness Considerations

Several studies have analyzed the cost-effectiveness of Y-90, showing that while the initial procedure cost is high, it can be a more cost-effective option over the long run. This is often due to a greater probability of extending life-years gained or increasing the quality of life, which offsets the higher initial price. A 2018 study found that due to an increased number of procedures, the overall cost of multiple TACE sessions outweighed the cost of fewer Y-90 radioembolizations.

Navigating Insurance and Patient Responsibility

Most patients do not pay the full list price for Y-90 radioembolization out of pocket. Health insurance plays a critical role in covering the expenses. However, patients are still responsible for their portion of the cost, which can include co-pays, deductibles, and co-insurance.

Insurance Coverage

Medicare: Medicare, under the 2003 MMA, largely reimburses hospitals for the outpatient cost of Y-90 microspheres. Medicare Advantage plans must provide at least equivalent coverage to traditional Medicare.
Private Payers: Many private insurance companies have recognized the safety and effectiveness of Y-90 and offer coverage, especially for conditions like unresectable metastatic liver tumors from colorectal cancer.
Prior Authorization: Securing prior authorization from your insurance company is a crucial step that helps ensure coverage for the entire treatment work-up and procedure.

Out-of-Pocket Expenses

For patients with insurance, the out-of-pocket costs will depend on their specific plan. For uninsured or cash-paying patients, the expense can be significant, often starting from $25,000 or more for the procedure alone. It is essential for patients to work closely with their hospital or clinic to get a clear estimate of their potential financial responsibility before starting treatment.

Billing Challenges in Outpatient Facilities

Billing for Y-90, particularly in Outpatient-Based Labs (OBLs), can be complex. Insurance companies may not be familiar with such complex procedures performed in these settings, leading to potential denials or underpayments. This necessitates careful and accurate billing and documentation to minimize issues.

Conclusion

The question of how much does Y-90 cost has no single answer, as the total expense is a composite of many parts, including the cost of the microspheres, pre-procedure diagnostics, and professional and facility fees. While a single procedure can cost tens of thousands of dollars, a large portion is typically covered by insurance. The overall cost-effectiveness of Y-90 compared to other treatments, considering fewer required sessions and shorter hospital stays, is an important factor. Patients should work closely with their medical providers and insurance companies to understand their specific financial responsibilities and ensure proper coverage.

For additional information on the billing and coding process for Y-90 in certain settings, the Sirtex website offers helpful coding guides, such as this one.

Note: This article does not discuss Y-90 Zevalin, a different medication used for non-Hodgkin's Lymphoma, which has separate pricing. The information provided is specific to Y-90 radioembolization for liver tumors.

Frequently Asked Questions

A single Y-90 radioembolization procedure typically ranges from $30,000 to $35,000, with institutional studies reporting averages around $32,500. However, this is an estimate and the final cost depends on many factors, including the specific microspheres, facility, and diagnostic work-up.

Yes, most major health insurance plans, including Medicare, generally cover Y-90 radioembolization, especially for approved indications such as liver tumors. Coverage often depends on medical necessity and obtaining proper prior authorization from the insurer.

A single Y-90 procedure is typically more expensive than a single TACE procedure. However, Y-90 often requires fewer overall treatment sessions and is performed on an outpatient basis, which can lead to a lower total treatment cost compared to multiple TACE procedures requiring hospital stays.

Multiple factors influence the final cost, including the specific type of Y-90 microspheres used (glass or resin), the facility type (hospital vs. outpatient lab), required diagnostic imaging, the number of treatment sessions, and professional fees for the physicians and specialists involved.

For insured patients, out-of-pocket costs depend on their specific health plan's deductible, co-insurance, and co-payment obligations. Uninsured patients will be responsible for the entire cost, which can be $25,000 or more per treatment.

Billing for complex procedures like Y-90 in outpatient-based labs (OBLs) can be complex because some commercial payers may not be familiar with these services outside a hospital setting. This can lead to delays or denials in reimbursement.

Yes, studies have shown that Y-90 can be a cost-effective option, particularly when compared to other therapies like TACE, due to a lower overall number of procedures and associated costs. A cost-effectiveness ratio also considers the quality-adjusted life years gained from the treatment.