HCPCS A9567
Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries
Current codeMyocardial Perfusion Scan28 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 | — | $233 | $583 |
| Cascade Valley Hospital | $383 | $307 | $383 |
| Deaconess Medical Center | — | $490 | $1,224 |
| EvergreenHealth Medical Center | — | $137 | $171 |
| Highline Medical Center | — | $104 | $342 |
| Kadlec Regional Medical Center | — | — | — |
| Mary Bridge Children's Hospital | — | $488 | $1,221 |
| MultiCare Auburn Medical Center | — | $488 | $1,221 |
| MultiCare Covington Medical Center | — | $488 | $1,221 |
| MultiCare Good Samaritan Hospital | — | $488 | $1,221 |
| MultiCare Valley Hospital | — | $490 | $1,224 |
| Overlake Hospital Medical Center & Clinics | — | $303 | $605 |
| PeaceHealth Southwest Medical Cente | — | $186 | $285 |
| PeaceHealth St John Medical Center | — | $186 | $285 |
| PeaceHealth St Joseph Medical Center | — | $186 | $285 |
| PeaceHealth United General Medical Center | — | $186 | $285 |
| Providence Centralia Hospital | — | $179 | $344 |
| Providence St Peter Hospital | — | $179 | $344 |
| Skagit Valley Hospital | $266 | $307 | $383 |
| St Anthony Hospital | — | $104 | $342 |
| St Clare Hospital | — | $98.63 | $342 |
| St Elizabeth Hospital | $58.17 – $70.83 | $121 | $342 |
| St Francis Community Hospital | — | $107 | $342 |
| St Joseph Medical Center | — | $113 | $342 |
| St Michael Medical Center | — | $151 | $342 |
| Tacoma General Allenmore Hospital | — | $488 | $1,221 |
| Virginia Mason Medical Center | — | $163 | $319 |
| Yakima Valley Memorial | — | $332 | $829 |
Medicare (traditional) reference
CMS publishes no national amount for this code.