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NDC 45567055501

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

Reported by 46 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

$82

Average

$378

Median

$110

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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