Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Radiophar Tc99M Sestamibi Dose
Low
$1
Average
$502
Median
$189
High
$5.4k
Each hospital's average Premera rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 11.2× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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40 hospital rates
iThe hospitals that file a Premera rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Public Hospital Dist No 1 Skagit dba Cascade Valley Hospital Arlington, WA fee schedule · both | 1 | $5.4k | $5.4k | — | — | 13 | $5.4k – $5.4k |
| 2 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 3 | $106 | $104 | $4 | 4% | 2–20 | $97 – $106 |
| 3 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · both | 1 | $1.1k | $1.1k | — | — | 2–20 | $1.1k – $1.1k |
| 4 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | — | — | 1–10 | $1 – $1 |
| 5 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 5 | $74 | $82 | $53 | 65% | 1–10 | $26 – $166 |
| 6 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · inpatient | 1 | $212 | $212 | — | — | — | $212 – $212 |
| 7 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · outpatient | 1 | $226 | $226 | — | — | — | $226 – $226 |
| 8 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $504 | $504 | — | — | — | $504 – $504 |
| 9 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient | 1 | $117 | $117 | — | — | — | $117 – $117 |
| 10 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $232 | $232 | — | — | — | $232 – $232 |
| 11 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 12 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 13 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $234 | $234 | — | — | — | $234 – $234 |
| 14 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $222 | $222 | — | — | — | $222 – $222 |
| 15 | Mercy Fitzgerald Hospital Darby, PA facility · fee schedule · both | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 16 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $218 | $218 | — | — | — | $218 – $218 |
| 17 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 18 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $223 | $223 | — | — | — | $223 – $223 |
| 19 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · inpatient | 1 | $128 | $128 | — | — | — | $128 – $128 |
| 20 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 1 | $128 | $128 | — | — | — | $128 – $128 |
| 21 | Mount Carmel East Reynoldsburg, OH facility · other · outpatient | 1 | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 22 | Mount Sinai Rehabilitation Hospital, Inc Hartford, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 23 | Nazareth Hospital Philadelphia, PA facility · fee schedule · both | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 24 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $194 | $194 | — | — | — | $194 – $194 |
| 25 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · fee schedule · both | 1 | $226 | $226 | — | — | — | $226 – $226 |
← Payers reporting HCPCS A9500 · Snapshot 20261111T120946Z-9134e7f7