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
TC-99M TEBOROXIME PER STY DOSE
Prices here combine facility and professional fees. See them separately →Experimental
Low
$53
Average
$317
Median
$419
High
$445
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 8 hospitals; the 90th percentile is 3.6× 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 | Northside Hospital, Inc. Lawrenceville, GA | $279 | $429 | $373 | 87% | — | $150 – $1.7k |
| 2 | Northside Hospital, Inc. Atlanta, GA | $279 | $445 | $376 | 84% | — | $162 – $1.7k |
| 3 | University Medical Center of Southern Nevada Las Vegas, NV | $53 | $53 | — | — | — | $53 – $53 |
| 4 | Nationwide Children's Hospital Columbus, OH | $199 | $199 | — | — | — | $199 – $199 |
| 5 | Northside Hospital, Inc. Cumming, GA | $279 | $425 | $391 | 92% | — | $120 – $1.7k |
| 6 | Nationwide Children's Hospital Toledo, Llc Toledo, OH | $148 | $147 | $1 | 0% | — | $146 – $148 |
| 7 | Northside Hospital, Inc. Duluth, GA | $279 | $415 | $383 | 92% | — | $126 – $1.7k |
| 8 | Northside Hospital, Inc. Canton, GA | $279 | $423 | $393 | 93% | — | $112 – $1.7k |
Ask Claude or any MCP client for HCPCS A9501 pricing at a specific hospital — see how to connect.