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
Radiophar Tc99M Sestamibi Dose
Low
$0
Average
$411
Median
$292
High
$10.2k
Each hospital's average Medica rate, under the methodology and billing class chosen below.
244 hospitals; the 90th percentile is 4.9× 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.
Filter by billing methodology
Filter by billing class
367 hospital rates
iThe hospitals that file a Medica rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 4 | $926 | $637 | $369 | 58% | 14 | $84 – $970 |
| 2 | HealthEast St John's Hospital Maplewood, MN other · inpatient | 1 | $105 | $105 | — | — | 6–60 | $105 – $105 |
| 3 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 12 | $268 | $297 | $177 | 60% | 6–60 | $71 – $504 |
| 4 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 4 | $926 | $637 | $369 | 58% | 4–40 | $84 – $970 |
| 5 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient | 4 | $926 | $637 | $369 | 58% | 4–40 | $84 – $970 |
| 6 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · outpatient | 4 | $926 | $637 | $369 | 58% | 4–40 | $84 – $970 |
| 7 | GOOD SAMARITAN HOSPITAL Kearney, NE fee schedule · outpatient | 4 | $630 | $551 | $404 | 73% | 3–30 | $72 – $970 |
| 8 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 7 | $489 | $451 | $83 | 18% | 3–30 | $268 – $504 |
| 9 | Mayo Clinic Health System Eau Claire 54703-5270 facility · percent of total billed charges · bothfrom % of charges | 8 | $260 | $299 | $173 | 58% | 3–30 | $104 – $504 |
| 10 | Westfields Hospital New Richmond, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $270 | $304 | $175 | 58% | 3–30 | $120 – $655 |
| 11 | Amery Hospital Amery, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $418 | $535 | $377 | 71% | 2–20 | $148 – $1.2k |
| 12 | Avera Heart Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $543 | $543 | $48 | 9% | 2–20 | $496 – $591 |
| 13 | Lakeview Hospital Stillwater, MN facility · percent of total billed charges · bothfrom % of charges | 2 | $348 | $345 | $102 | 29% | 2–20 | $203 – $482 |
| 14 | Mayo Clinic Health System Fairmont 56031-4575 facility · percent of total billed charges · bothfrom % of charges | 7 | $203 | $287 | $175 | 61% | 2–20 | $73 – $504 |
| 15 | NEBRASKA HEART HOSPITAL Lincoln, NE fee schedule · outpatient | 4 | $703 | $647 | $308 | 48% | 2–20 | $234 – $970 |
| 16 | Avera Marshall Hospital Marshall, MN percent of total billed charges · outpatientfrom % of charges | 2 | $324 | $324 | $31 | 10% | 1–10 | $292 – $355 |
| 17 | Avera McKennan Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $450 | $450 | $34 | 8% | 1–10 | $416 – $484 |
| 18 | Avera Milbank Hospital Milbank, SD percent of total billed charges · outpatientfrom % of charges | 2 | $408 | $408 | $35 | 9% | 1–10 | $373 – $443 |
| 19 | Avera Sacred Heart Hospital Yankton, SD percent of total billed charges · outpatientfrom % of charges | 2 | $1.1k | $1.1k | $98 | 9% | 1–10 | $1.0k – $1.2k |
| 20 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · outpatientfrom % of charges | 2 | $606 | $606 | $52 | 9% | 1–10 | $554 – $658 |
| 21 | Avera St. Luke's Aberdeen, SD percent of total billed charges · outpatientfrom % of charges | 2 | $508 | $508 | $43 | 8% | 1–10 | $466 – $551 |
| 22 | Hudson Hospital Hudson, WI facility · percent of total billed charges · bothfrom % of charges | 3 | $270 | $306 | $165 | 54% | 1–10 | $169 – $622 |
| 23 | Jefferson County Hospital OK Waurika, OK percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $47 | — | — | 1–10 | $47 – $47 |
| 24 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 5 | $249 | $295 | $173 | 59% | 1–10 | $98 – $504 |
| 25 | Mercy Hospital Springfield Ozark, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $301 | $301 | — | — | 1–10 | $301 – $301 |
← Payers reporting HCPCS A9500 · Snapshot 20261111T120946Z-9134e7f7