HCPCS A9521
Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
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 | — | $2,045 – $3,463 | $5,112 – $8,658 |
| Deaconess Medical Center | — | $2,952 | $7,381 |
| Highline Medical Center | — | $960 | $3,144 |
| Mary Bridge Children's Hospital | — | $3,463 | $8,658 |
| MultiCare Auburn Medical Center | — | $3,463 | $8,658 |
| MultiCare Covington Medical Center | — | $3,463 | $8,658 |
| MultiCare Good Samaritan Hospital | — | $3,463 | $8,658 |
| MultiCare Valley Hospital | — | $2,952 | $7,381 |
| Providence Centralia Hospital | — | $4,113 | $7,909 |
| Providence St Peter Hospital | — | $4,113 | $7,909 |
| Skagit Valley Hospital | — | $3,144 | $3,930 |
| St Anthony Hospital | — | $956 | $3,144 |
| St Clare Hospital | — | $906 | $3,144 |
| St Elizabeth Hospital | $880 – $1,043 | $1,111 | $3,144 |
| St Francis Community Hospital | — | $987 | $3,144 |
| St Joseph Medical Center | — | $1,041 | $3,144 |
| St Michael Medical Center | — | $1,388 | $3,144 |
| Tacoma General Allenmore Hospital | — | $3,463 – $3,570 | $8,658 – $8,926 |
| Yakima Valley Memorial | — | $422 | $1,054 |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Hospital outpatient payment (national)
- $928 (APC 0766)
- Surgery center payment (national)
- $928