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 THE PREPARATION OF GA-68-DOTATATE 40 MCG INTRAVENOUS SOLN
Low
$44
Average
$3.7k
Median
$3.1k
High
$16.4k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
59 hospitals; the 90th percentile is 196.0× 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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83 hospital rates
iThe hospitals that file a Wellmark 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 | Avera McKennan Hospital Sioux Falls, SD case rate · outpatient | 2 | $6.0k | $6.0k | — | — | 2–20 | $6.0k – $6.0k |
| 2 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 3 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 3 | $56 | $56 | — | — | — | $56 – $56 |
| 4 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 5 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 6 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 7 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · both | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 8 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 9 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · other · both | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 10 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $8.0k | $8.0k | — | — | — | $8.0k – $8.0k |
| 11 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 12 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 3 | $56 | $56 | — | — | — | $56 – $56 |
| 13 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 3 | $56 | $56 | — | — | — | $56 – $56 |
| 14 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 15 | Covenant Medical Center Inc Waterloo, IA facility · other · both | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 16 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 17 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 3 | $56 | $56 | — | — | — | $56 – $56 |
| 18 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $16.3k | $16.3k | — | — | — | $16.3k – $16.3k |
| 19 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 20 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $16.4k | $16.4k | — | — | — | $16.4k – $16.4k |
| 21 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $15.6k | $15.6k | — | — | — | $15.6k – $15.6k |
| 22 | Mercy Fitzgerald Hospital Darby, PA facility · fee schedule · both | 1 | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 23 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $6.3k | $6.3k | — | — | — | $6.3k – $6.3k |
| 24 | Mercy Medical Center - Dubuque Dubuque, IA facility · fee schedule · both | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 25 | Mercy Medical Center - Dubuque Dubuque, IA facility · other · both | 1 | $49 | $49 | — | — | — | $49 – $49 |
← Payers reporting HCPCS A9587 · Snapshot 20261111T120946Z-9134e7f7