HCPCS A9539
Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries
Current codeMyocardial Perfusion Scan39 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 | $437 – $508 | $239 | $598 |
| Cascade Valley Hospital | $29.22 – $4,425 | $275 | $344 |
| Deaconess Medical Center | $400 – $785 | $430 | $1,076 |
| EvergreenHealth Medical Center | $31.96 – $93.83 | — | $1.00 |
| Highline Medical Center | $55.90 – $117 | $39.70 | $130 |
| Island Hospital | $4.08 – $171 | $51.00 – $180 | $51.00 – $180 |
| Kadlec Regional Medical Center | $44.36 – $95.87 | — | — |
| Mary Bridge Children's Hospital | $660 – $832 | $409 | $1,022 |
| MultiCare Auburn Medical Center | $746 | $409 | $1,022 |
| MultiCare Covington Medical Center | $746 | $409 | $1,022 |
| MultiCare Good Samaritan Hospital | $746 | $409 | $1,022 |
| MultiCare Valley Hospital | $400 – $775 | $430 | $1,076 |
| Overlake Hospital Medical Center & Clinics | $59.45 – $63.28 | — | — |
| PeaceHealth Peace Island Medical Center | — | $185 | $285 |
| PeaceHealth Southwest Medical Cente | — | $185 | $285 |
| PeaceHealth St John Medical Center | — | $185 – $186 | $285 – $285 |
| PeaceHealth St Joseph Medical Center | — | $185 | $285 |
| PeaceHealth United General Medical Center | — | $185 | $285 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $39.29 | — | — |
| Providence Centralia Hospital | $75.69 – $95.87 | $347 | $667 |
| Providence Holy Family Hospital | $39.29 | — | — |
| Providence Regional Medical Center Everett | $39.29 | — | — |
| Providence St Peter Hospital | — | $347 | $667 |
| Skagit Valley Hospital | $37.81 – $327 | $210 – $275 | $262 – $344 |
| St Anthony Hospital | $93.60 – $97.50 | $39.54 | $130 |
| St Clare Hospital | $93.60 – $97.50 | $37.48 | $130 |
| St Elizabeth Hospital | $43.29 – $117 | $45.94 | $130 |
| St Francis Community Hospital | $93.60 – $97.50 | $40.80 | $130 |
| St Joseph Medical Center | $93.60 – $97.50 | $43.06 | $130 |
| St Michael Medical Center | $83.20 – $117 | $57.38 | $130 |
| Swedish Edmonds Hospital | $39.29 | — | — |
| Swedish Issaquah | $39.29 | — | — |
| Swedish Medical Center | $39.29 | — | — |
| Swedish Medical Center / Cherry Hill | $39.29 | — | — |
| Tacoma General Allenmore Hospital | $746 | $409 | $1,022 |
| Trios Health | — | — | $669 |
| Virginia Mason Medical Center | $640 – $854 | $544 | $1,067 |
| WhidbeyHealth Medical Center | — | $634 | $634 |
| Yakima Valley Memorial | $517 – $1,006 | $422 – $473 | $1,056 – $1,184 |
Medicare (traditional) reference
CMS publishes no national amount for this code.