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
TECHNETIUM TC 99M PENTETATE FOR BRAIN DEATH IDENTIFICATION
Low
$1
Average
$177
Median
$122
High
$2.4k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
282 hospitals; the 90th percentile is 19.7× 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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340 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 | ARH Tug Valley Health Services, Inc. Prestonsburg, KY percent of total billed charges · outpatientfrom % of charges | 1 | $36 | $36 | — | — | 1–10 | $36 – $36 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $114 | $114 | — | — | — | $114 – $114 |
| 3 | ARH Mary Breckinridge Health Services, Inc Barbourville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 4 | ARH Mary Breckinridge Health Services, Inc Martin, KY percent of total billed charges · outpatientfrom % of charges | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 5 | ARH Tug Valley Health Services, Inc. Paintsville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 6 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient | 2 | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 7 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 2 | $33 | $33 | $0 | 0% | — | $33 – $33 |
| 8 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 4 | $25 | $26 | $3 | 12% | — | $23 – $30 |
| 9 | Appalachian Regional Healthcare, Inc. Liberty, KY percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 10 | Appalachian Regional Healthcare, Inc. Whitesburg, KY percent of total billed charges · outpatientfrom % of charges | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 11 | Appalachian Regional Healthcare, Inc. Middlesboro, KY percent of total billed charges · outpatientfrom % of charges | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 12 | Appalachian Regional Healthcare, Inc. Williamson, KY percent of total billed charges · outpatientfrom % of charges | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 13 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $209 | $209 | — | — | — | $209 – $209 |
| 14 | Appalachian Regional Healthcare, Inc. Harlan, KY percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 15 | Aurora BayCare Medical Center Green Bay, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 16 | Aurora Lakeland Medical Center Elkhorn, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 17 | Aurora Medical Center Bay Area Marinette, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 18 | Aurora Medical Center Burlington Burlington, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 19 | Aurora Medical Center Fond du Lac Fond Du Lac, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 20 | Aurora Medical Center Grafton Grafton, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 21 | Aurora Medical Center Kenosha Kenosha, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 22 | Aurora Medical Center Manitowoc Two Rivers, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 23 | Aurora Medical Center Mount Pleasant Mount Pleasant, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 24 | Aurora Medical Center Oshkosh Oshkosh, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
| 25 | Aurora Medical Center Sheboygan County Sheboygan, WI percent of total billed charges · outpatientfrom % of charges | 1 | $210 | $210 | — | — | — | $210 – $210 |
← Payers reporting HCPCS A9539 · Snapshot 20261111T120946Z-9134e7f7