HCPCS A9569
Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose
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 | $934 – $11,645 | $4,648 | $11,621 |
| Deaconess Medical Center | $934 – $7,738 | $4,083 | $10,208 |
| Harborview Medical Center | $1,495 – $2,028 | — | — |
| Highline Medical Center | $1,040 – $4,751 | $1,612 | $5,279 |
| Island Hospital | $1,746 – $1,964 | — | — |
| Kadlec Regional Medical Center | $1,579 – $3,953 | — | — |
| Mary Bridge Children's Hospital | $934 – $18,758 | $4,648 | $11,621 |
| MultiCare Auburn Medical Center | $934 – $8,483 | $4,648 | $11,621 |
| MultiCare Covington Medical Center | $934 – $8,483 | $4,648 | $11,621 |
| MultiCare Good Samaritan Hospital | $934 – $8,483 | $4,648 | $11,621 |
| MultiCare Valley Hospital | $934 – $7,738 | $4,083 | $10,208 |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $936 – $3,462 | — | — |
| PeaceHealth Peace Island Medical Center | — | $2,961 | $4,555 |
| PeaceHealth Southwest Medical Cente | $374 – $3,031 | $2,961 | $4,555 |
| PeaceHealth St John Medical Center | $374 – $934 | $2,961 | $4,555 |
| PeaceHealth St Joseph Medical Center | $934 | $2,961 | $4,555 |
| PeaceHealth United General Medical Center | — | $2,961 | $4,555 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1,579 – $3,099 | — | — |
| Providence Centralia Hospital | $1,579 – $3,953 | $4,160 | $8,000 |
| Providence Holy Family Hospital | $1,121 – $3,425 | — | — |
| Providence Regional Medical Center Everett | $1,121 – $2,897 | — | — |
| Providence St Peter Hospital | — | $4,160 | $8,000 |
| Seattle Children's Hospital | $2,822 – $5,016 | $5,225 | $5,225 |
| St Anthony Hospital | $1,040 – $5,188 | $1,605 | $5,279 |
| St Clare Hospital | $1,040 – $5,188 | $1,522 | $5,279 |
| St Elizabeth Hospital | $1,040 – $4,751 | $1,865 | $5,279 |
| St Francis Community Hospital | $1,040 – $5,188 | $1,657 | $5,279 |
| St Joseph Medical Center | $1,040 – $5,188 | $1,748 | $5,279 |
| St Michael Medical Center | $2,425 – $4,751 | $2,330 | $5,279 |
| Swedish Edmonds Hospital | $1,401 – $3,363 | — | — |
| Swedish Issaquah | $1,401 – $3,962 | — | — |
| Swedish Medical Center | $1,401 – $3,962 | — | — |
| Swedish Medical Center / Cherry Hill | $1,401 – $3,962 | — | — |
| Tacoma General Allenmore Hospital | $934 – $8,483 | $4,648 | $11,621 |
| University of Washington Medical Ctr | $1,332 – $2,930 | — | — |
| Virginia Mason Medical Center | $1,040 – $3,690 | $2,240 | $4,393 |
| Wellfound Behavioral Health Hospital | $2,357 | — | — |
| Yakima Valley Memorial | $1,465 – $1,925 | — | — |
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)
- $934 (APC 0776)
- Surgery center payment (national)
- $934