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
$1
Average
$17
Median
$18
High
$27
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
45 hospitals; the 90th percentile is 1.8× 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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45 hospital rates
iThe hospitals that file a Ambetter 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 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY other · outpatient | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 2 | BAPTIST HEALTHCARE SYSTEM INC Albany, IN other · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 3 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY other · outpatient | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 4 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY other · outpatient | 2 | $20 | $20 | — | — | — | $20 – $20 |
| 5 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY other · outpatient | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 6 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY other · outpatient | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 7 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY other · outpatient | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 8 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY other · outpatient | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 9 | Baxter County Regional Hospital, Inc. Home, AR facility · fee schedule · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 10 | Deaconess Hospital, Inc Newburgh, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 11 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 12 | Hendrick Medical Center Brownwood, TX facility · case rate · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 13 | Indiana University Health Arnett Inc. Lafayette, IN fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 14 | Indiana University Health Ball Memorial Hospital Inc. Muncie, IN fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 15 | Indiana University Health Bloomington Inc. Bloomington, IN fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 16 | Indiana University Health Inc. Martinsville, IN fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 17 | Indiana University Health North Hospital Inc. Carmel, IN fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 18 | Indiana University Health West Hospital Inc. Avon, IN fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 19 | Inspira Medical Center Mullica Hill Hill, NJ fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 20 | Inspira Medical Center Vineland Vineland, NJ fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 21 | Lakewood Medical Center Kansas City, MO facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 22 | MultiCare Auburn Medical Center Auburn, WA fee schedule · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 23 | MultiCare Capital Medical Center Lacey, WA fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 24 | MultiCare Covington Medical Center Covington, WA fee schedule · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 25 | MultiCare Deaconess Hospital Spokane, WA fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
← Payers reporting HCPCS C9176 · Snapshot 20261111T120946Z-9134e7f7