APC 776
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
A9569 Tc-99m Exametazime Auto WBC DX SD
Low
$934
Average
$1.0k
Median
$943
High
$1.7k
Filter by billing methodology
Prices here combine facility and professional fees. See them separately →Experimental
Reflects a negotiated per diem rate paid per day of care.
Showing only prices reported under the per diem methodology. Choose another in the filter above to change the chart. 17 hospitals; the 90th percentile is 1.2× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Fairfield Medical Center Lancaster, OH | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 2 | Triad of Alabama LLC Dothan, AL | $934 | $934 | — | — | — | $934 – $934 |
| 3 | Porter Hospital LLC Valparaiso, IN | $934 | $934 | — | — | — | $934 – $934 |
| 4 | Affinity Hospital LLC Birmingham, AL | $934 | $1.2k | $330 | 28% | — | $934 – $1.6k |
| 5 | Dupont Hospital LLC Wayne, IN | $934 | $934 | — | — | — | $934 – $934 |
| 6 | Foley Hospital Company LLC Foley, AL | $934 | $934 | — | — | — | $934 – $934 |
| 7 | La Porte Hospital Company LLC La Porte, IN | $934 | $934 | — | — | — | $934 – $934 |
| 8 | Northwest Hospital LLC Tucson, AZ | $943 | $943 | $9 | 1% | — | $934 – $953 |
| 9 | Northwest Sahurita Hospital LLC Tucson, AZ | $943 | $943 | $9 | 1% | — | $934 – $953 |
| 10 | Moberly Hospital Company LLC Moberly, MO | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
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