HCPCS A9520
Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries
Current codeMyocardial Perfusion Scan30 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 | — | $819 – $1,892 | $2,048 – $4,731 |
| Deaconess Medical Center | — | $749 – $1,513 | $1,873 – $3,783 |
| EvergreenHealth Medical Center | — | $1,647 | $2,059 |
| Highline Medical Center | — | $225 | $736 |
| Mary Bridge Children's Hospital | — | $1,670 | $4,174 |
| MultiCare Auburn Medical Center | — | $1,670 | $4,174 |
| MultiCare Covington Medical Center | — | $1,670 | $4,174 |
| MultiCare Good Samaritan Hospital | — | $552 – $1,670 | $1,379 – $4,174 |
| MultiCare Valley Hospital | — | $1.48 – $1,513 | $3.68 – $3,783 |
| Overlake Hospital Medical Center & Clinics | — | $1,396 | $2,792 |
| Providence Regional Medical Center Everett | — | $1,140 | $2,192 |
| Providence St Peter Hospital | — | $1,140 | $2,192 |
| St Anthony Hospital | — | $224 | $736 |
| St Clare Hospital | — | $212 | $736 |
| St Elizabeth Hospital | $206 – $244 | $260 | $736 |
| St Francis Community Hospital | — | $231 | $736 |
| St Joseph Medical Center | — | $244 | $736 |
| St Michael Medical Center | — | $325 | $736 |
| Tacoma General Allenmore Hospital | — | $1,670 | $4,174 |
| Virginia Mason Medical Center | — | $958 | $1,879 |
| Yakima Valley Memorial | — | $53.60 – $956 | $134 – $2,389 |
Medicare (traditional) reference
CMS publishes no national amount for this code.