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
TC99M DISOFENIN PER STUDY DOSE =< 15 MCI ; X1 MAX [NM]
Low
$36
Average
$155
Median
$132
High
$288
Each hospital's average Devoted rate, under the methodology and billing class chosen below.
19 hospitals; the 90th percentile is 6.2× 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.
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19 hospital rates
iThe hospitals that file a Devoted 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 | Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $160 | $160 | — | — | — | $160 – $160 |
| 2 | Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 3 | Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 4 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $197 | $197 | — | — | — | $197 – $197 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Canon City, CO percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 6 | CHRISTUS Hospital - Orange Orange, TX percent of total billed charges · outpatientfrom % of charges | 1 | $288 | $288 | — | — | — | $288 – $288 |
| 7 | CHRISTUS West Beaumont Beaumont, TX percent of total billed charges · outpatientfrom % of charges | 1 | $288 | $288 | — | — | — | $288 – $288 |
| 8 | Christus Health Southeast Texas Beaumont, TX percent of total billed charges · outpatientfrom % of charges | 1 | $288 | $288 | — | — | — | $288 – $288 |
| 9 | Christus Health Southeast Texas Port Arthur, TX percent of total billed charges · outpatientfrom % of charges | 1 | $288 | $288 | — | — | — | $288 – $288 |
| 10 | Dickenson Community Hospital CLINTWOOD, VA percent of total billed charges · bothfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 11 | Hilton Head Medical Center LLC Hilton Head Island, SC percent of total billed charges · bothfrom % of charges | 2 | $132 | $132 | — | — | — | $132 – $132 |
| 12 | Johnson County Community Hospital MOUNTAIN CITY, TN percent of total billed charges · bothfrom % of charges | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 13 | Lee County Community Hospital PENNINGTON GAP, VA percent of total billed charges · bothfrom % of charges | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 14 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 15 | Mercy Hospital Aurora Aurora, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $83 | $83 | — | — | — | $83 – $83 |
| 16 | Mercy Hospital Cassville Knob, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 17 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $96 | $96 | — | — | — | $96 – $96 |
| 18 | NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK Tillamook, OR percent of total billed charges · outpatientfrom % of charges | 1 | $89 | $89 | $5 | 6% | — | $84 – $94 |
| 19 | Southeast Texas Orthopedic Specialty Center Port Arthur, TX percent of total billed charges · outpatientfrom % of charges | 1 | $288 | $288 | — | — | — | $288 – $288 |
← Payers reporting HCPCS A9510 · Snapshot 20261111T120946Z-9134e7f7