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
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $4,648 | $11,621 |
| Deaconess Medical Center | — | $4,083 | $10,208 |
| Highline Medical Center | — | $1,612 | $5,279 |
| Mary Bridge Children's Hospital | — | $4,648 | $11,621 |
| MultiCare Auburn Medical Center | — | $4,648 | $11,621 |
| MultiCare Covington Medical Center | — | $4,648 | $11,621 |
| MultiCare Good Samaritan Hospital | — | $4,648 | $11,621 |
| MultiCare Valley Hospital | — | $4,083 | $10,208 |
| Providence Centralia Hospital | — | $4,160 | $8,000 |
| Providence St Peter Hospital | — | $4,160 | $8,000 |
| Seattle Children's Hospital | — | $5,225 | $5,225 |
| St Anthony Hospital | — | $1,605 | $5,279 |
| St Clare Hospital | — | $1,522 | $5,279 |
| St Elizabeth Hospital | — | $1,865 | $5,279 |
| St Francis Community Hospital | — | $1,657 | $5,279 |
| St Joseph Medical Center | — | $1,748 | $5,279 |
| St Michael Medical Center | — | $2,330 | $5,279 |
| Tacoma General Allenmore Hospital | — | $4,648 | $11,621 |
| Virginia Mason Medical Center | — | $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