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
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage 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 |
| Harborview Medical Center | $928 – $1,020 | — | — |
| Highline Medical Center | $893 – $1,027 | $960 | $3,144 |
| Island Hospital | $1,084 – $1,149 | — | — |
| Kadlec Regional Medical Center | — | — | — |
| 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 |
| Olympic Medical Center | $1,138 – $1,463 | — | — |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| PeaceHealth Peace Island Medical Center | — | $2,307 | $3,549 |
| PeaceHealth Southwest Medical Cente | $928 – $1,067 | $2,307 – $2,307 | $3,549 – $3,549 |
| PeaceHealth St John Medical Center | $724 – $1,020 | $2,307 | $3,549 |
| PeaceHealth St Joseph Medical Center | $928 – $1,020 | $2,307 | $3,549 |
| PeaceHealth United General Medical Center | — | $2,307 | $3,549 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | — | — |
| Providence Centralia Hospital | — | $4,113 | $7,909 |
| Providence Holy Family Hospital | — | — | — |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Peter Hospital | — | $4,113 | $7,909 |
| Skagit Valley Hospital | $802 – $842 | $3,144 | $3,930 |
| St Anthony Hospital | $909 – $1,046 | $956 | $3,144 |
| St Clare Hospital | $909 – $1,046 | $906 | $3,144 |
| St Elizabeth Hospital | $566 – $692 | $1,111 | $3,144 |
| St Francis Community Hospital | $893 – $1,027 | $987 | $3,144 |
| St Joseph Medical Center | $909 – $1,046 | $1,041 | $3,144 |
| St Michael Medical Center | $935 – $1,010 | $1,388 | $3,144 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | — | — |
| Swedish Medical Center | — | — | — |
| Swedish Medical Center / Cherry Hill | — | — | — |
| Tacoma General Allenmore Hospital | — | $3,463 – $3,570 | $8,658 – $8,926 |
| University of Washington Medical Ctr | $928 – $1,020 | — | — |
| Virginia Mason Medical Center | $562 – $842 | — | — |
| 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