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
Non-Heu Tc-99m Add-on per Dose
Low
$0
Average
$52
Median
$6
High
$2.2k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
58 hospitals; the 90th percentile is 24.9× 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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78 hospital rates
iThe hospitals that file a Wellmark 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 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 2 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 3 | $10 | $10 | — | — | — | $10 – $10 |
| 3 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 4 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 5 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 3 | $10 | $10 | — | — | — | $10 – $10 |
| 6 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 3 | $10 | $10 | — | — | — | $10 – $10 |
| 7 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 8 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 3 | $10 | $10 | — | — | — | $10 – $10 |
| 9 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 10 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 11 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 12 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 13 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 14 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 15 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 16 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 17 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Mercy Medical Center - Dubuque Dubuque, IA facility · other · outpatient | 1 | $393 | $393 | — | — | — | $393 – $393 |
| 19 | Mercy Medical Center - Dyersville Dyersville, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 20 | Mercy Medical Center - New Hampton New Hampton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | MercyOne Genesis Davenport Medical Center IA 52803; 2140 53rd Avenue Bettendorf, IA facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 22 | MercyOne Genesis Davenport West Medical Center Davenport, IA facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 23 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 24 | Meriter Hospital, Inc Madison, WI case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 25 | Meriter Hospital, Inc Madison, WI percent of total billed charges · bothfrom % of charges | 1 | $3 | $3 | — | — | — | $3 – $3 |
← Payers reporting HCPCS Q9969 · Snapshot 20261111T120946Z-9134e7f7