HCPCS A9500
Technetium tc-99m sestamibi, diagnostic, per study dose
Current codeMyocardial Perfusion Scan35 hospitals with prices
What Washington hospitals publish for this code
Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.
| Hospital | Medicaid (state program) rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| BHC Fairfax Hospital | — | $317 | $317 |
| Capital Medical Center | — | $672 | $1,680 |
| Cascade Valley Hospital | — | $129 | $162 |
| Deaconess Medical Center | — | $49.20 – $99.60 | $123 – $249 |
| EvergreenHealth Medical Center | — | $554 | $693 |
| Highline Medical Center | — | $193 | $633 |
| Kadlec Regional Medical Center | — | — | — |
| Legacy Salmon Creek Medical Center | — | $293 | $451 |
| Mary Bridge Children's Hospital | — | $104 | $261 |
| MultiCare Auburn Medical Center | — | $104 – $104 | $259 – $261 |
| MultiCare Covington Medical Center | — | $104 | $261 |
| MultiCare Good Samaritan Hospital | — | $1.89 – $104 | $4.71 – $261 |
| MultiCare Valley Hospital | — | $98.40 – $99.60 | $246 – $249 |
| Overlake Hospital Medical Center & Clinics | — | $74.48 | $149 |
| PeaceHealth Peace Island Medical Center | — | $97.76 – $125 | $150 – $192 |
| PeaceHealth Southwest Medical Cente | — | $97.76 – $250 | $150 – $385 |
| PeaceHealth St John Medical Center | — | $97.76 – $250 | $150 – $385 |
| PeaceHealth St Joseph Medical Center | — | $97.76 – $125 | $150 – $192 |
| PeaceHealth United General Medical Center | — | $97.76 – $125 | $150 – $192 |
| 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 | $11.91 – $50.51 | $47.25 – $200 | $47.25 – $200 |
| Skagit Valley Hospital | — | $129 – $750 | $162 – $937 |
| St Anthony Hospital | — | $193 | $633 |
| St Clare Hospital | — | $182 | $633 |
| St Elizabeth Hospital | — | $224 | $633 |
| St Francis Community Hospital | — | $199 | $633 |
| St Joseph Medical Center | — | $210 | $633 |
| St Michael Medical Center | — | $279 | $633 |
| Tacoma General Allenmore Hospital | — | $104 – $104 | $259 – $261 |
| Trios Health | — | — | $1,835 |
| Virginia Mason Medical Center | — | $63.75 | $125 |
| WhidbeyHealth Medical Center | — | $732 | $732 |
| Yakima Valley Memorial | — | $97.60 – $1,782 | $244 – $4,456 |
Medicare (traditional) reference
CMS publishes no national amount for this code.