HCPCS A9502
Technetium tc-99m tetrofosmin, diagnostic, per study dose
Current codeMyocardial Perfusion Scan38 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) |
|---|---|---|---|
| Capital Medical Center | $229 – $1,428 | $126 – $672 | $314 – $1,680 |
| Cascade Valley Hospital | $15.44 – $1,575 | $145 – $149 | $182 – $186 |
| Deaconess Medical Center | $113 – $221 | $121 | $303 |
| EvergreenHealth Medical Center | $86.98 – $762 | $655 | $819 |
| Highline Medical Center | $272 – $570 | $193 | $633 |
| Island Hospital | $6.72 – $79.80 | $84.00 | $84.00 |
| Kadlec Regional Medical Center | $121 – $600 | — | — |
| Mary Bridge Children's Hospital | $203 – $256 | $126 | $314 |
| MultiCare Auburn Medical Center | $229 | $126 | $314 |
| MultiCare Covington Medical Center | $229 | $126 | $314 |
| MultiCare Good Samaritan Hospital | $229 | $126 | $314 |
| MultiCare Valley Hospital | $113 – $218 | $121 | $303 |
| Overlake Hospital Medical Center & Clinics | $162 – $172 | $60.08 | $120 |
| PeaceHealth Peace Island Medical Center | — | $112 | $172 |
| PeaceHealth Southwest Medical Cente | — | $112 | $172 |
| PeaceHealth St John Medical Center | — | $112 | $172 |
| PeaceHealth St Joseph Medical Center | — | $112 – $248 | $172 – $381 |
| PeaceHealth United General Medical Center | — | $112 – $248 | $172 – $381 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $107 | — | — |
| Providence Centralia Hospital | $474 – $600 | $83.14 | $160 |
| Providence Holy Family Hospital | $107 | — | — |
| Providence Regional Medical Center Everett | $107 | — | — |
| Providence St Peter Hospital | — | $83.14 | $160 |
| Skagit Valley Hospital | $26.20 – $366 | $145 – $308 | $182 – $385 |
| St Anthony Hospital | $456 – $475 | $193 | $633 |
| St Clare Hospital | $456 – $475 | $182 | $633 |
| St Elizabeth Hospital | $211 – $570 | $224 | $633 |
| St Francis Community Hospital | $456 – $475 | $199 | $633 |
| St Joseph Medical Center | $456 – $475 | $210 | $633 |
| St Michael Medical Center | $405 – $570 | $279 | $633 |
| Swedish Edmonds Hospital | $107 | — | — |
| Swedish Issaquah | $107 | — | — |
| Swedish Medical Center | $107 | — | — |
| Swedish Medical Center / Cherry Hill | $107 | — | — |
| Tacoma General Allenmore Hospital | $229 | $126 | $314 |
| Virginia Mason Medical Center | $81.60 – $109 | $69.36 | $136 |
| WhidbeyHealth Medical Center | — | $488 | $488 |
| Yakima Valley Memorial | $120 – $207 | $97.60 | $244 |
Medicare (traditional) reference
CMS publishes no national amount for this code.