HCPCS A9500
Technetium tc-99m sestamibi, diagnostic, per study dose
Current codeMyocardial Perfusion Scan35 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| BHC Fairfax Hospital | $120 – $222 | $317 | $317 |
| Capital Medical Center | $1,344 – $1,428 | $672 | $1,680 |
| Cascade Valley Hospital | $13.75 – $1,406 | $129 | $162 |
| Deaconess Medical Center | $87.33 – $182 | $49.20 – $99.60 | $123 – $249 |
| EvergreenHealth Medical Center | $95.82 – $644 | $554 | $693 |
| Highline Medical Center | $272 – $570 | $193 | $633 |
| Legacy Salmon Creek Medical Center | — | $293 | $451 |
| Mary Bridge Children's Hospital | $171 – $209 | $104 | $261 |
| MultiCare Auburn Medical Center | $153 – $191 | $104 – $104 | $259 – $261 |
| MultiCare Covington Medical Center | $154 – $191 | $104 | $261 |
| MultiCare Good Samaritan Hospital | $2.78 – $191 | $1.89 – $104 | $4.71 – $261 |
| MultiCare Valley Hospital | $177 – $179 | $98.40 – $99.60 | $246 – $249 |
| Overlake Hospital Medical Center & Clinics | — | $74.48 | $149 |
| Providence Centralia Hospital | — | $69.53 | $134 |
| Providence St Mary Medical Center | — | $93.60 | $134 |
| Providence St Peter Hospital | — | $69.53 | $134 |
| Seattle Children's Hospital | $25.52 – $192 | $47.25 – $200 | $47.25 – $200 |
| Skagit Valley Hospital | $23.35 – $890 | $129 – $750 | $162 – $937 |
| St Anthony Hospital | $456 – $475 | $193 | $633 |
| St Clare Hospital | $456 – $475 | $182 | $633 |
| St Elizabeth Hospital | $228 – $570 | $224 | $633 |
| St Francis Community Hospital | $456 – $475 | $199 | $633 |
| St Joseph Medical Center | $456 – $475 | $210 | $633 |
| St Michael Medical Center | $399 – $570 | $279 | $633 |
| Tacoma General Allenmore Hospital | $153 – $191 | $104 – $104 | $259 – $261 |
| Trios Health | — | — | $1,835 |
| Virginia Mason Medical Center | $80.06 – $100 | $63.75 | $125 |
| Yakima Valley Memorial | $137 – $2,495 | $97.60 – $1,782 | $244 – $4,456 |
Medicare (traditional) reference
CMS publishes no national amount for this code.