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
KIT FOR PREPARATION OF TC-99M-BICISATE 0.9 MG INTRAVENOUS SOLUTION
Low
$1
Average
$806
Median
$487
High
$5.2k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
33 hospitals; the 90th percentile is 2043.0× 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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36 hospital rates
iThe hospitals that file a Medicaid 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 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $487 | $487 | — | — | — | $487 – $487 |
| 2 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 3 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 4 | Allina Health Systems Ulm, MN facility · other · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $776 | $776 | — | — | — | $776 – $776 |
| 6 | Chapman Global Medical Center Orange, CA facility · fee schedule · outpatient | 1 | $339 | $339 | — | — | — | $339 – $339 |
| 7 | Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient | 2 | $318 | $318 | — | — | — | $318 – $318 |
| 8 | Childrens Hospital of Los Angeles Angeles, CA professional · fee schedule · outpatient | 2 | $48 | $48 | — | — | — | $48 – $48 |
| 9 | Eisenhower Medical Center Rancho Mirage, CA fee schedule · both | 3 | $339 | $339 | — | — | — | $339 – $339 |
| 10 | Geisinger Bloomsburg Hospital Bloomsburg, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 11 | Geisinger Community Medical Center Scranton, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 12 | Geisinger Jersey Shore Hospital Jersey Shore, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 13 | Geisinger Lewistown Hospital Lewistown, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 14 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 15 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 16 | HANFORD COMMUNITY HOSPITAL Selma, CA fee schedule · outpatient | 1 | $487 | $487 | — | — | — | $487 – $487 |
| 17 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $487 | $487 | — | — | — | $487 – $487 |
| 18 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 19 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 3 | $609 | $419 | $274 | 65% | — | $32 – $615 |
| 20 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 3 | $609 | $419 | $274 | 65% | — | $32 – $615 |
| 21 | Mercy Hospital Oklahoma City Inc City, OK facility · fee schedule · outpatient | 2 | $320 | $320 | $288 | 90% | — | $32 – $609 |
| 22 | Mercy Hospital Rogers dba Mercy Hospital Northwest Arkansas Rogers, AR facility · fee schedule · outpatient | 3 | $609 | $419 | $274 | 65% | — | $32 – $615 |
| 23 | Mercy Hospital Springfield Ozark, MO facility · fee schedule · outpatient | 3 | $609 | $419 | $274 | 65% | — | $32 – $615 |
| 24 | Mercy Hospital Springfield Springfield, MO facility · fee schedule · outpatient | 3 | $609 | $419 | $274 | 65% | — | $32 – $615 |
| 25 | Northwest Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $542 | $542 | — | — | — | $542 – $542 |
← Payers reporting HCPCS A9557 · Snapshot 20261111T120946Z-9134e7f7