Code: A9584

Description:

Description: Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental

Other Descriptions:

HC IODINE I-123 IOFLUPANE

HC RP DAT SCAN I 123 IOFLUPANE

IODINE I-123 IOFLUPANE DX-STUDY DOSE UP 5 MCI

I-123 IOFLUPANE (DATASCAN) DOSE

Ioflupane I-123 Up To 5 Mci

Related codes:

Code: A9580

Description: Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental

Code: A9581

Description: Injection, gadoxetate disodium, 1 ml
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental

Code: A9582

Description: Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental

Code: A9583

Description: Injection, gadofosveset trisodium, 1 ml
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental

Code: A9585

Description: Injection, gadobutrol, 0.1 ml
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental

Code: A9586

Description: Florbetapir f18, diagnostic, per study dose, up to 10 millicuries
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental

Code: A9587

Description: Gallium ga-68, dotatate, diagnostic, 0.1 millicurie
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental

Code: A9588

Description: Fluciclovine f-18, diagnostic, 1 millicurie
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental

Code: A9589

Description: Instillation, hexaminolevulinate hydrochloride, 100 mg
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental

Nebraska

Hospital	Address	Code	Price	Last Updated
Chi Health Good Samaritan	10 E 31St St, Kearney	A9584	$19,474 [source]	4 years ago
Chi Health Lakeside	17201 Wright St, Omaha	A9584	$19,474 [source]	4 years ago
Chi Health Midlands	11111 S 84Th St, Papillion	A9584	$19,474 [source]	4 years ago
Chi Health Creighton University Medical Center - Bergan Mercy	7500 Mercy Rd, Omaha	A9584	$19,474 [source]	4 years ago
Chi Health Immanuel	7101 Newport Ave, Omaha	A9584	$19,474 [source]	4 years ago
Chi Health St. Francis	2116 W Faidley Ave, Grand Island	A9584	$19,474 [source]	4 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR §180.