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 | $9,297 – $9,878 | $4,648 | $11,621 |
| Deaconess Medical Center | $7,248 – $7,452 | $4,083 | $10,208 |
| Highline Medical Center | $2,270 – $4,751 | $1,612 | $5,279 |
| Mary Bridge Children's Hospital | $7,600 – $9,297 | $4,648 | $11,621 |
| MultiCare Auburn Medical Center | $6,856 – $8,483 | $4,648 | $11,621 |
| MultiCare Covington Medical Center | $6,856 – $8,483 | $4,648 | $11,621 |
| MultiCare Good Samaritan Hospital | $6,856 – $8,483 | $4,648 | $11,621 |
| MultiCare Valley Hospital | $7,350 | $4,083 | $10,208 |
| Providence Centralia Hospital | — | $4,160 | $8,000 |
| Providence St Peter Hospital | — | $4,160 | $8,000 |
| Seattle Children's Hospital | $2,822 – $5,016 | $5,225 | $5,225 |
| St Anthony Hospital | $3,801 – $3,959 | $1,605 | $5,279 |
| St Clare Hospital | $3,801 – $3,959 | $1,522 | $5,279 |
| St Elizabeth Hospital | $1,900 – $4,751 | $1,865 | $5,279 |
| St Francis Community Hospital | $3,801 – $3,959 | $1,657 | $5,279 |
| St Joseph Medical Center | $3,801 – $3,959 | $1,748 | $5,279 |
| St Michael Medical Center | $3,325 – $4,751 | $2,330 | $5,279 |
| Tacoma General Allenmore Hospital | $6,856 – $8,483 | $4,648 | $11,621 |
| Virginia Mason Medical Center | $2,814 – $3,514 | $2,240 | $4,393 |
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