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
$29
Median
$11
High
$199
Each hospital's average Molina rate, under the methodology and billing class chosen below.
105 hospitals; the 90th percentile is 16.0× 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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110 hospital rates
iThe hospitals that file a Molina 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $114 | $114 | — | — | — | $114 – $114 |
| 2 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 3 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 4 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 5 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $15 | $15 | $5 | 34% | — | $10 – $21 |
| 6 | Bronson Battle Creek Hospital Battle Creek, MI facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 7 | Bronson LakeView Hospital Paw Paw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 8 | Bronson Methodist Hospital Kalamazoo, MI facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 9 | Bronson South Haven Hospital South Haven, MI facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 10 | CATHOLIC HEALTH INITIATIVES COLORADO West Valley City, UT fee schedule · outpatient | 2 | $15 | $15 | $5 | 35% | — | $10 – $21 |
| 11 | CATHOLIC HEALTH INITIATIVES COLORADO West Jordan, UT fee schedule · outpatient | 2 | $15 | $15 | $5 | 35% | — | $10 – $21 |
| 12 | CATHOLIC HEALTH INITIATIVES COLORADO Lehi, UT fee schedule · outpatient | 2 | $15 | $15 | $5 | 35% | — | $10 – $21 |
| 13 | CATHOLIC HEALTH INITIATIVES COLORADO Layton, UT fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 14 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 15 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 16 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $199 | $199 | — | — | — | $199 – $199 |
| 17 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 18 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 19 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 20 | Carle BroMenn Medical Center Normal, IL case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 21 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $111 | $111 | — | — | — | $111 – $111 |
| 22 | Covenant Medical Center Inc Saginaw, MI facility · case rate · outpatient | 2 | $8 | $8 | $2 | 31% | — | $5 – $10 |
| 23 | Covenant Medical Center Inc Saginaw, MI facility · case rate · outpatient | 2 | $8 | $8 | $2 | 31% | — | $5 – $10 |
| 24 | Deaconess Hospital, Inc Newburgh, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | Deaconess Illinois Union County Hospital Inc Anna, IL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Payers reporting HCPCS C9176 · Snapshot 20261111T120946Z-9134e7f7