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
$23
Average
$440
Median
$263
High
$1.5k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
87 hospitals; the 90th percentile is 14.3× 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.
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91 hospital rates
iThe hospitals that file a Tricare 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 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $271 | $271 | — | — | 2–20 | $271 – $271 |
| 2 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $342 | $415 | $126 | 30% | 1–10 | $342 – $633 |
| 3 | Saint Francis Hospital and Medical Center Hartford, CT professional · percent of total billed charges · bothfrom % of charges | 1 | $106 | $106 | — | — | 1–10 | $106 – $106 |
| 4 | Springhill Memorial Hospital Mobile, AL other · outpatient | 1 | $61 | $61 | — | — | 1–10 | $61 – $61 |
| 5 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $672 | $672 | — | — | — | $672 – $672 |
| 6 | Aspirus Wausau Hospital Wausau, WI fee schedule · both | 1 | $880 | $880 | — | — | — | $880 – $880 |
| 7 | Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $65 | $85 | $42 | 49% | — | $53 – $156 |
| 8 | Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $82 | $41 | 49% | — | $51 – $151 |
| 9 | Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $82 | $41 | 49% | — | $51 – $151 |
| 10 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $71 | $75 | $10 | 13% | — | $65 – $88 |
| 11 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 1 | $266 | $266 | $87 | 33% | — | $179 – $353 |
| 12 | Calhoun Liberty Hospital Association Inc Blountstown, FL percent of total billed charges · bothfrom % of charges | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 13 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 14 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $284 | $284 | — | — | — | $284 – $284 |
| 15 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 16 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $191 | $191 | — | — | — | $191 – $191 |
| 17 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $263 | $263 | $6 | 2% | — | $257 – $270 |
| 18 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $764 | $1.0k | $360 | 35% | — | $764 – $1.5k |
| 19 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 1 | $145 | $145 | $2 | 1% | — | $143 – $147 |
| 20 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 21 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $490 | $490 | $186 | 38% | — | $304 – $675 |
| 22 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $459 | $459 | $174 | 38% | — | $285 – $633 |
| 23 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges | 1 | $186 | $186 | $53 | 29% | — | $133 – $240 |
| 24 | HSA CGH LLC Coral Gables, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $668 | $668 | — | — | — | $668 – $668 |
| 25 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $812 | $812 | — | — | — | $812 – $812 |
← Payers reporting HCPCS A9500 · Snapshot 20261111T120946Z-9134e7f7