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  4. /HCPCS A9501
HCPCS A9501

TC-99M TEBOROXIME PER STY DOSE at Northside Hospital, Inc.

Canton, GA

Pricing by billing methodology

Price type

All methodologies

$650

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

$1k

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

$665

Reflects a negotiated percentage of total billed charges.

Other

$279

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

Last updated: Feb 14, 2026

Compare to other hospitals

See TC-99M TEBOROXIME PER STY DOSE pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.

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