HCPCS A9502
Technetium tc-99m tetrofosmin, diagnostic, per study dose
Current codeMyocardial Perfusion Scan38 hospitals with prices
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $126 – $672 | $314 – $1,680 |
| Cascade Valley Hospital | $182 – $186 | $145 – $149 | $182 – $186 |
| Deaconess Medical Center | — | $121 | $303 |
| EvergreenHealth Medical Center | — | $655 | $819 |
| Highline Medical Center | — | $193 | $633 |
| Island Hospital | $42.00 | $84.00 | $84.00 |
| Mary Bridge Children's Hospital | — | $126 | $314 |
| MultiCare Auburn Medical Center | — | $126 | $314 |
| MultiCare Covington Medical Center | — | $126 | $314 |
| MultiCare Good Samaritan Hospital | — | $126 | $314 |
| MultiCare Valley Hospital | — | $121 | $303 |
| Overlake Hospital Medical Center & Clinics | — | $60.08 | $120 |
| Providence Centralia Hospital | — | $83.14 | $160 |
| Providence St Peter Hospital | — | $83.14 | $160 |
| Skagit Valley Hospital | $233 | $145 – $308 | $182 – $385 |
| St Anthony Hospital | — | $193 | $633 |
| St Clare Hospital | — | $182 | $633 |
| St Elizabeth Hospital | $177 – $210 | $224 | $633 |
| St Francis Community Hospital | — | $199 | $633 |
| St Joseph Medical Center | — | $210 | $633 |
| St Michael Medical Center | — | $279 | $633 |
| Tacoma General Allenmore Hospital | — | $126 | $314 |
| Virginia Mason Medical Center | — | $69.36 | $136 |
| Yakima Valley Memorial | — | $97.60 | $244 |
Medicare (traditional) reference
CMS publishes no national amount for this code.