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
$1
Average
$174
Median
$125
High
$1.4k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
132 hospitals; the 90th percentile is 5.3× 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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154 hospital rates
iThe hospitals that file a Molina 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $114 | $114 | — | — | — | $114 – $114 |
| 2 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient | 2 | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 3 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 2 | $59 | $59 | $0 | 0% | — | $58 – $59 |
| 4 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 4 | $44 | $45 | $6 | 12% | — | $40 – $54 |
| 5 | Aurora Medical Center Bay Area Marinette, WI percent of total billed charges · outpatientfrom % of charges | 1 | $459 | $459 | — | — | — | $459 – $459 |
| 6 | Baptist Anderson Regional Medical Center Meridian, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 7 | Baptist Anderson Regional Medical Center Meridian, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 8 | Baptist Anderson Regional Medical Center-South Meridian, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 9 | Baptist Anderson Regional Medical Center-South Meridian, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 10 | Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges | 3 | $157 | $201 | $63 | 31% | — | $157 – $290 |
| 11 | Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges | 3 | $152 | $196 | $61 | 31% | — | $152 – $282 |
| 12 | Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges | 3 | $152 | $196 | $61 | 31% | — | $152 – $282 |
| 13 | Baptist Memorial Hospital-Booneville Booneville, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $224 | $224 | — | — | — | $224 – $224 |
| 14 | Baptist Memorial Hospital-Booneville Booneville, MS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $224 | $224 | — | — | — | $224 – $224 |
| 15 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 3 | $193 | $247 | $77 | 31% | — | $193 – $357 |
| 16 | Baptist Memorial Hospital-Collierville Collierville, TN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $224 | $224 | — | — | — | $224 – $224 |
| 17 | Baptist Memorial Hospital-Collierville Collierville, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $224 | $224 | — | — | — | $224 – $224 |
| 18 | Baptist Memorial Hospital-DeSoto Southaven, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $224 | $224 | — | — | — | $224 – $224 |
| 19 | Baptist Memorial Hospital-DeSoto Southaven, MS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $224 | $224 | — | — | — | $224 – $224 |
| 20 | Baptist Memorial Hospital-Golden Triangle Columbus, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $224 | $224 | — | — | — | $224 – $224 |
| 21 | Baptist Memorial Hospital-Golden Triangle Columbus, MS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $224 | $224 | — | — | — | $224 – $224 |
| 22 | Baptist Memorial Hospital-Memphis Memphis, TN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $224 | $224 | — | — | — | $224 – $224 |
| 23 | Baptist Memorial Hospital-Memphis Memphis, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $224 | $224 | — | — | — | $224 – $224 |
| 24 | Baptist Memorial Hospital-North Mississippi Oxford, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $189 | $189 | $35 | 19% | — | $154 – $224 |
| 25 | Baptist Memorial Hospital-North Mississippi Oxford, MS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $189 | $189 | $35 | 19% | — | $154 – $224 |
← Payers reporting HCPCS A9510 · Snapshot 20261111T120946Z-9134e7f7