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NDC 45567055501

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

Reported by 46 hospitals in the network.

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.

National pricing summary

Low

$82

Average

$386

Median

$111

High

$1.0k

Hospitals reporting this code

#HospitalLocation
1IHC Health Services Inc., DBA Intermountain Health Intermountain Medical CenterMurray, UT$16$979$887$1.2k$256
2IHC Health Services Inc., DBA Intermountain Health Utah Valley HospitalProvo, UT$19$979$900$1.2k$245
3IHC Health Services Inc., DBA Intermountain Health McKay-Dee HospitalOgden, UT$14$979$899$1.4k$254
4IHC Health Services Inc., DBA Intermountain Health St George Regional HospitalSt. George, UT$21$944$898$997$166
5IHC Health Services Inc., DBA Intermountain Health LDS HospitalSalt Lake City, UT$18$979$894$1.2k$248
6IHC Health Services Inc., DBA Intermountain Health Logan Regional HospitalLogan, UT$23$942$881$1.1k$206
7IHC Health Services Inc., DBA Intermountain Health American Fork HospitalAmerican Fork, UT$24$965$893$1.2k$238
8IHC Health Services Inc., DBA Intermountain Health Layton HospitalLayton, UT$56$972$890$1.4k$252
9IHC Health Services, Inc,. DBA Intermountain Health Alta View HospitalSandy, UT$39$965$881$1.2k$249
10IHC Health Services Inc., DBA Intermountain Primary Children's HospitalCity, UT$344$698$726$841$98
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