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  4. /NDC 9999910740

NDC 9999910740

99M SESTAMIBI DX PER STUDY DOSE at Commonspirit Kansas, Inc.

Ulysses, KS

Pricing by billing methodology

Price type

All methodologies

$368

Aggregated across all available billing methodologies for this code.

Case rate

Not reported

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

Fee schedule

$287

Reflects negotiated fee schedule rates with commercial payers.

Per diem

Not reported

Reflects a negotiated per diem rate paid per day of care.

Percent of billed charges

$375

Reflects a negotiated percentage of total billed charges.

Other

—

Reflects a payer-specific billing methodology not covered by the standard categories.

Last updated: Feb 3, 2026

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