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  5. /Percent of billed charges

NDC 11994000320

KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION

Reported by 21 hospitals in the network under the percent of billed charges methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated percentage of total billed charges.

National pricing summary

Low

$214

Average

$321

Median

$267

High

$532

Hospitals reporting this code

#HospitalLocation
1IHC Health Services Inc., DBA Intermountain Health Intermountain Medical CenterMurray, UT$5$291$264$364$76
2IHC Health Services Inc., DBA Intermountain Health Utah Valley HospitalProvo, UT$6$291$267$364$73
3IHC Health Services Inc., DBA Intermountain Health McKay-Dee HospitalOgden, UT$4$291$267$404$76
4IHC Health Services Inc., DBA Intermountain Health St George Regional HospitalSt. George, UT$6$279$265$294$49
5IHC Health Services Inc., DBA Intermountain Health LDS HospitalSalt Lake City, UT$5$291$266$364$74
6Scl Health - Montana, Dba Intermountain Health St. Vincent HealthcareBillings, MT$300$446$441$521$69
7Saint Joseph Hospital, Inc. Dba Intermountain Nhealth Saint Joseph HospitalDENVER, CO$174$539$532$942$228
8IHC Health Services Inc., DBA Intermountain Health Logan Regional HospitalLogan, UT$7$278$260$314$61
9St. Mary's Hospital & Medical Center, Inc. Dba Intermountain Health St. Mary's Regional HospitalJUNCTION, CO$197$474$418$549$97
10IHC Health Services Inc., DBA Intermountain Health American Fork HospitalAmerican Fork, UT$7$287$265$364$71
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