HCPCS A9540
Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries
Current codeMyocardial Perfusion Scan40 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 | — | $147 – $170 | $367 – $424 |
| Cascade Valley Hospital | $395 | $316 | $395 |
| Deaconess Medical Center | — | $436 – $440 | $1,090 – $1,101 |
| EvergreenHealth Medical Center | — | $178 | $222 |
| Highline Medical Center | — | $69.21 | $227 |
| Island Hospital | $109 | $218 | $218 |
| Kadlec Regional Medical Center | — | — | — |
| Mary Bridge Children's Hospital | — | $418 | $1,044 |
| MultiCare Auburn Medical Center | — | $414 – $418 | $1,035 – $1,044 |
| MultiCare Covington Medical Center | — | $414 – $418 | $1,035 – $1,044 |
| MultiCare Good Samaritan Hospital | — | $414 – $418 | $1,035 – $1,044 |
| MultiCare Valley Hospital | — | $436 – $440 | $1,090 – $1,101 |
| Overlake Hospital Medical Center & Clinics | — | $370 – $1,625 | $740 – $3,251 |
| PeaceHealth Peace Island Medical Center | — | $276 – $515 | $425 – $793 |
| PeaceHealth Southwest Medical Cente | — | $276 – $515 | $425 – $793 |
| PeaceHealth St John Medical Center | — | $276 – $515 | $425 – $793 |
| PeaceHealth St Joseph Medical Center | — | $276 – $515 | $425 – $793 |
| PeaceHealth United General Medical Center | — | $276 – $515 | $425 – $793 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | — | — |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | — | — |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Peter Hospital | — | $334 | $642 |
| Seattle Children's Hospital | $708 – $896 | $2,755 | $2,755 |
| Skagit Valley Hospital | $266 | $316 – $446 | $395 – $557 |
| St Anthony Hospital | — | $68.94 | $227 |
| St Clare Hospital | — | $65.33 | $227 |
| St Elizabeth Hospital | $38.54 – $46.92 | $80.10 | $227 |
| St Francis Community Hospital | — | $71.13 | $227 |
| St Joseph Medical Center | — | $75.07 | $227 |
| St Michael Medical Center | — | $100 | $227 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | — | — |
| Swedish Medical Center | — | — | — |
| Swedish Medical Center / Cherry Hill | — | — | — |
| Tacoma General Allenmore Hospital | — | $414 – $418 | $1,035 – $1,044 |
| Trios Health | — | — | $617 |
| Virginia Mason Medical Center | — | $275 | $540 |
| WhidbeyHealth Medical Center | — | $387 | $387 |
| Yakima Valley Memorial | — | $353 – $3,826 | $882 – $9,566 |
Medicare (traditional) reference
CMS publishes no national amount for this code.