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
PERFLUTREN PROTEIN-TYPE A MICROSPHERES 0.22 MG/ML INTRAVENOUS SUSP
Low
$41
Average
$485
Median
$506
High
$964
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
22 hospitals; the 90th percentile is 20.0× 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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22 hospital rates
iThe hospitals that file a Tricare 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 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $276 | $276 | $6 | 2% | 1–10 | $270 – $281 |
| 2 | Aspirus Rhinelander Hospital Rhinelander, WI fee schedule · both | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 3 | Aspirus Wausau Hospital Wausau, WI fee schedule · both | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 4 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $917 | $917 | — | — | — | $917 – $917 |
| 5 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $917 | $917 | — | — | — | $917 – $917 |
| 6 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $408 | $408 | $168 | 41% | — | $240 – $576 |
| 7 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $964 | $964 | $593 | 61% | — | $372 – $1.6k |
| 8 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $128 | $128 | — | — | — | $128 – $128 |
| 9 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $917 | $917 | — | — | — | $917 – $917 |
| 10 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · fee schedule · outpatient | 1 | $81 | $81 | $4 | 4% | — | $77 – $84 |
| 11 | Mayo Clinic Health System Sparta, WI professional · fee schedule · outpatient | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 12 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $237 | $237 | — | — | — | $237 – $237 |
| 13 | Morristown Medical Center Morristown, NJ other · outpatient | 2 | $917 | $917 | — | — | — | $917 – $917 |
| 14 | Newton Medical Center Newton, NJ other · outpatient | 2 | $917 | $917 | — | — | — | $917 – $917 |
| 15 | Overlook Medical Center Summit, NJ other · outpatient | 2 | $917 | $917 | — | — | — | $917 – $917 |
| 16 | Penn Medicine Princeton Medical Center Princeton, NJ facility · fee schedule · outpatient | 1 | $506 | $506 | — | — | — | $506 – $506 |
| 17 | Pennsylvania Hospital of the University of Pennsylvania Health System Philadelphia, PA facility · fee schedule · outpatient | 1 | $506 | $506 | — | — | — | $506 – $506 |
| 18 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · fee schedule · outpatient | 1 | $506 | $506 | — | — | — | $506 – $506 |
| 19 | The Chester County Hospital West Chester, PA facility · fee schedule · outpatient | 1 | $506 | $506 | — | — | — | $506 – $506 |
| 20 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA facility · fee schedule · outpatient | 1 | $531 | $531 | $25 | 5% | — | $506 – $556 |
| 21 | University of Texas MD Anderson Cancer Center The University of Texas M D Anderson Cancer Center Houston, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $320 | $320 | — | — | — | $320 – $320 |
| 22 | VALLEY REGIONAL HOSPITAL CLAREMONT, NH percent of total billed charges · bothfrom % of charges | 1 | $83 | $83 | — | — | — | $83 – $83 |
← Payers reporting HCPCS Q9956 · Snapshot 20261111T120946Z-9134e7f7