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
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 | — | $239 | $598 |
| Cascade Valley Hospital | $344 | $275 | $344 |
| Deaconess Medical Center | — | $430 | $1,076 |
| EvergreenHealth Medical Center | — | — | $1.00 |
| Highline Medical Center | — | $39.70 | $130 |
| Island Hospital | $25.50 – $90.00 | $51.00 – $180 | $51.00 – $180 |
| Mary Bridge Children's Hospital | — | $409 | $1,022 |
| MultiCare Auburn Medical Center | — | $409 | $1,022 |
| MultiCare Covington Medical Center | — | $409 | $1,022 |
| MultiCare Good Samaritan Hospital | — | $409 | $1,022 |
| MultiCare Valley Hospital | — | $430 | $1,076 |
| Providence Centralia Hospital | — | $347 | $667 |
| Providence St Peter Hospital | — | $347 | $667 |
| Skagit Valley Hospital | $266 | $210 – $275 | $262 – $344 |
| St Anthony Hospital | — | $39.54 | $130 |
| St Clare Hospital | — | $37.48 | $130 |
| St Elizabeth Hospital | $36.40 – $43.13 | $45.94 | $130 |
| St Francis Community Hospital | — | $40.80 | $130 |
| St Joseph Medical Center | — | $43.06 | $130 |
| St Michael Medical Center | — | $57.38 | $130 |
| Tacoma General Allenmore Hospital | — | $409 | $1,022 |
| Trios Health | — | — | $669 |
| Virginia Mason Medical Center | — | $544 | $1,067 |
| Yakima Valley Memorial | — | $422 – $473 | $1,056 – $1,184 |
Medicare (traditional) reference
CMS publishes no national amount for this code.