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
$9
Average
$11
Median
$10
High
$14
Each hospital's average Medical Mutual rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 1.3× 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
21 hospital rates
iThe hospitals that file a Medical Mutual 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 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 3 | $12 | $12 | — | — | — | $12 – $12 |
| 2 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $12 | $11 | $2 | 22% | — | $7 – $12 |
| 3 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 4 | Adena Health System Chillicothe, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 5 | Adena Health System Chillicothe, OH facility · percent of total billed charges · outpatientfrom % of charges | 2 | $9 | $9 | $1 | 16% | — | $7 – $10 |
| 6 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 7 | Greenfield Area Medical Center Greenfield, OH facility · percent of total billed charges · inpatientfrom % of charges | 2 | $12 | $12 | — | — | — | $12 – $12 |
| 8 | Greenfield Area Medical Center Greenfield, OH facility · percent of total billed charges · outpatientfrom % of charges | 2 | $12 | $12 | — | — | — | $12 – $12 |
| 9 | McCullough-Hyde Memorial Hospital, Inc. Oxford, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 10 | Pike Health Services Inc Waverly, OH facility · percent of total billed charges · inpatientfrom % of charges | 2 | $12 | $12 | — | — | — | $12 – $12 |
| 11 | Pike Health Services Inc Waverly, OH facility · percent of total billed charges · outpatientfrom % of charges | 3 | $12 | $9 | $4 | 40% | — | $4 – $12 |
| 12 | The Good Samaritan Hospital of Cincinnati, OH Cincinnati, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 13 | University Hospitals Health System Chardon, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 14 | University Hospitals Health System Ravenna, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 15 | University Hospitals Health System Chardon, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 16 | University Hospitals Health System Beachwood, OH facility · fee schedule · outpatient | 5 | $16 | $14 | $2 | 16% | — | $10 – $16 |
| 17 | University Hospitals Health System Concord Township, OH facility · fee schedule · outpatient | 5 | $15 | $14 | $2 | 14% | — | $10 – $15 |
| 18 | University Hospitals Health System Cleveland, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 19 | University Hospitals Health System Parma, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 20 | University Hospitals Health System Beachwood, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 21 | University Hospitals Health System Elyria, OH facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
← Payers reporting HCPCS C9176 · Snapshot 20261111T120946Z-9134e7f7