Technetium Tc-99m teboroxime imaging agent

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.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Technetium TC-99m teboroxime

Payers reporting HCPCS A9501

Payer pricing summary

Low

Average

$1.1k

Median

$132

High

$19.0k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +6 other terms	50	$265	$262	$110	42%	—	$76 – $640
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +7 other terms	30	$511	$500	$516	103%	—	$0 – $2.7k
3	Anthem facility · case rate · outpatient · +5 other terms	15	$117	$128	$30	23%	—	$80 – $199
4	Caresource facility · case rate · outpatient · +5 other terms	15	$120	$128	$29	23%	—	$80 – $203
5	Molina facility · case rate · outpatient · +3 other terms	15	$117	$128	$30	23%	—	$82 – $199
6	UnitedHealthcare facility · case rate · outpatient · +2 other terms	15	$120	$130	$30	23%	—	$82 – $203
7	MultiPlan percent of total billed charges · outpatientfrom % of charges · +1 other terms	14	$76	$324	$363	112%	—	$48 – $850
8	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$386	$245	$214	87%	—	$0 – $483
9	Optum facility · case rate · outpatient · +1 other terms	11	$111	$121	$27	22%	—	$100 – $180
10	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$80	$80	—	—	—	$80 – $80
11	Cigna other · outpatient · +1 other terms	5	$152	$156	$11	7%	—	$144 – $174
12	Humana fee schedule · inpatient · +3 other terms	5	$78	$78	—	—	—	$78 – $78
13	Kaiser percent of total billed charges · outpatientfrom % of charges	5	$726	$726	$105	14%	—	$650 – $870
14	Oscar percent of total billed charges · outpatientfrom % of charges	5	$470	$470	—	—	—	$470 – $470
15	Phcs percent of total billed charges · outpatientfrom % of charges	5	$750	$750	—	—	—	$750 – $750
16	Tricare fee schedule · outpatient	5	$1k	$1k	—	—	—	$1k – $1k
17	Beechstreet percent of total billed charges · outpatientfrom % of charges	4	$66	$68	$4	5%	—	$66 – $75
18	First Health professional · fee schedule · both · +1 other terms	3	$86	$86	—	—	—	$86 – $86
19	Bcbs Id facility · fee schedule · outpatient	2	$1.3k	$1.0k	$801	78%	—	$455 – $2.2k
20	Magellan percent of total billed charges · outpatientfrom % of charges	2	$50	$50	—	—	—	$50 – $50
21	Bcbs Nv other · outpatient	1	$53	$53	—	—	—	$53 – $53
22	Bcbs Vt professional · fee schedule · outpatient	1	$119	$119	—	—	—	$119 – $119
23	Cigna Healthspring percent of total billed charges · outpatientfrom % of charges	1	$6	$6	—	—	—	$6 – $6