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
$53
Average
$524
Median
$224
High
$1.4k
Each hospital's average Sanford Health Plan rate, under the methodology and billing class chosen below.
64 hospitals; the 90th percentile is 12.8× 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.
Filter by billing methodology
Filter by billing class
107 hospital rates
iThe hospitals that file a Sanford Health Plan 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 | Fairview Health Services Minneapolis, MN percent of total billed charges · inpatientfrom % of charges | 1 | $189 | $189 | — | — | 2–20 | $189 – $189 |
| 2 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $189 | $189 | — | — | 2–20 | $189 – $189 |
| 3 | CARRINGTON HEALTH CENTER Carrington, ND fee schedule · inpatient | 1 | $117 | $117 | — | — | — | $117 – $117 |
| 4 | CARRINGTON HEALTH CENTER Carrington, ND fee schedule · outpatient | 1 | $117 | $117 | — | — | — | $117 – $117 |
| 5 | Essentia Health Ada 201 9th St W Ada, MN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 6 | Essentia Health Ada 201 9th St W Ada, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 7 | Essentia Health Duluth Duluth, MN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 8 | Essentia Health Duluth Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 9 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · percent of total billed charges · inpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 10 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · percent of total billed charges · outpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 11 | Essentia Health Fosston 900 Hilligoss Blvd SE Fosston, MN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 12 | Essentia Health Fosston 900 Hilligoss Blvd SE Fosston, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 13 | Essentia Health St. Joseph's Medical Center Brainerd, MN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 14 | Essentia Health St. Joseph's Medical Center Brainerd, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 15 | Essentia Health St. Mary's Children's Hospital Duluth, MN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 16 | Essentia Health St. Mary's Children's Hospital Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 17 | Essentia Health St. Mary's Medical Center Duluth, MN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 18 | Essentia Health St. Mary's Medical Center Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $112 | $112 | $3 | 3% | — | $109 – $115 |
| 19 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · inpatientfrom % of charges | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 20 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · outpatientfrom % of charges | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 21 | Fairview Health Services Edina, MN percent of total billed charges · inpatientfrom % of charges | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 22 | Fairview Health Services Edina, MN percent of total billed charges · outpatientfrom % of charges | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 23 | Fairview Health Services Burnsville, MN percent of total billed charges · inpatientfrom % of charges | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 24 | Fairview Health Services Burnsville, MN percent of total billed charges · outpatientfrom % of charges | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 25 | Fairview Health Services Wyoming, MN percent of total billed charges · inpatientfrom % of charges | 1 | $189 | $189 | — | — | — | $189 – $189 |
← Payers reporting HCPCS A9539 · Snapshot 20261111T120946Z-9134e7f7