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
IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5 ML) INTRAVENOUS SOLUTION
Low
$1.2k
Average
$3.2k
Median
$1.4k
High
$13.1k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
72 hospitals; the 90th percentile is 7.9× 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
79 hospital rates
iThe hospitals that file a Tricare 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 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 1 | $1.4k | $1.4k | — | — | 1–10 | $1.4k – $1.4k |
| 2 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 1 | $1.4k | $1.4k | — | — | 1–10 | $1.4k – $1.4k |
| 3 | Mercy Hospital Springfield Ozark, MO facility · other · outpatient | 1 | $1.4k | $1.4k | — | — | 1–10 | $1.4k – $1.4k |
| 4 | Mercy Hospital Springfield Springfield, MO facility · other · outpatient | 1 | $1.4k | $1.4k | — | — | 1–10 | $1.4k – $1.4k |
| 5 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $6.2k | $6.2k | — | — | — | $6.2k – $6.2k |
| 6 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 7 | Boston Medical Center Boston, MA other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 8 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 9 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 10 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 11 | CentraState Medical Center Freehold Township, NJ other · both | 2 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 12 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 13 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 14 | Chilton Medical Center Pompton Plains, NJ other · both | 2 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 15 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 16 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 17 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 18 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 19 | Hackettstown Medical Center Hackettstown, NJ other · both | 2 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 20 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 21 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $13.0k | $13.0k | — | — | — | $13.0k – $13.0k |
| 22 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $13.1k | $13.1k | — | — | — | $13.1k – $13.1k |
| 23 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital City, UT facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 24 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital Lehi, UT facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 25 | KARMANOS CANCER CENTER DETROIT, MI fee schedule | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
← Payers reporting HCPCS A9584 · Snapshot 20261111T120946Z-9134e7f7