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
TC-99M FROM DOMESTICALLY PRODUCED NON-HEU MO-99, [MINIMUM 50 PERCENT], FULL COST RECOVERY ADD-ON, PER STUDY DOSE
Low
$0
Average
$4
Median
$5
High
$5
Each hospital's average Aetna Better Health rate, under the methodology and billing class chosen below.
7 hospitals; the 90th percentile is 19.8× 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.
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7 hospital rates
iThe hospitals that file a Aetna Better Health 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 | Deaconess Hospital, Inc Newburgh, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Deaconess Illinois Union County Hospital Inc Anna, IL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 4 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 5 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 6 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 7 | WA Foote Memorial Hospital Jackson, MI facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
← Payers reporting HCPCS C9176 · Snapshot 20261111T120946Z-9134e7f7