Technetium-99m tetrofosmin 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-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR Technetium Tc-99m Tetrofosmin per Study Dose

Payers reporting HCPCS A9502

Payer pricing summary

Low

$34

Average

$484

Median

$331

High

$3.9k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +26 other terms	433	$193	$322	$594	184%	191–290	$1 – $7.3k
2	Kaiser fee schedule · both · +17 other terms	49	$181	$190	$166	87%	117	$99 – $1.4k
3	Healthpartners facility · other · outpatient · +10 other terms	4	$157	$157	—	—	68	$157 – $157
4	Blue Cross Blue Shield fee schedule · outpatient · +28 other terms	235	$235	$300	$315	105%	58–94	$1 – $4.8k
5	Anthem fee schedule · outpatient · +22 other terms	85	$113	$155	$101	65%	22–112	$22 – $802
6	Bcbs Sc percent of total billed charges · bothfrom % of charges	1	$34	$34	—	—	21–30	$34 – $34
7	Medica fee schedule · outpatient · +18 other terms	24	$166	$192	$54	28%	3–30	$50 – $354
8	Cigna fee schedule · outpatient · +20 other terms	237	$149	$256	$217	85%	2–20	$13 – $1.5k
9	WellCare fee schedule · both · +13 other terms	7	$0	$63	$92	147%	1–10	$0 – $284
10	Aetna fee schedule · outpatient · +24 other terms	125	$205	$287	$275	96%	—	$1 – $1.5k
11	Humana fee schedule · outpatient · +19 other terms	95	$274	$486	$395	81%	—	$1 – $1.1k
12	MultiPlan fee schedule · outpatient · +15 other terms	60	$261	$300	$129	43%	—	$27 – $642
13	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +2 other terms	51	$455	$515	$384	75%	—	$24 – $1.7k
14	Molina fee schedule · outpatient · +19 other terms	29	$109	$236	$428	182%	—	$1 – $1.9k
15	Superior Healthplan percent of total billed charges · outpatientfrom % of charges · +1 other terms	29	$84	$98	$88	90%	—	$6 – $359
16	Caresource fee schedule · outpatient · +14 other terms	26	$230	$1.7k	$1.5k	85%	—	$1 – $3.1k
17	First Health fee schedule · inpatient · +14 other terms	24	$221	$236	$93	39%	—	$23 – $521
18	Phcs fee schedule · outpatient · +9 other terms	20	$196	$245	$102	42%	—	$125 – $473
19	Medicaid fee schedule · outpatient · +8 other terms	19	$294	$527	$616	117%	—	$1 – $1.9k
20	Bcbs Tx fee schedule · outpatient · +4 other terms	18	$470	$428	$99	23%	—	$156 – $661
21	Excellus facility · fee schedule · both · +7 other terms	17	$135	$157	$78	50%	—	$97 – $410
22	Premera facility · fee schedule · both · +8 other terms	17	$135	$167	$83	50%	—	$56 – $410
23	Regence facility · fee schedule · both · +13 other terms	17	$135	$170	$83	49%	—	$63 – $410
24	Tricare facility · fee schedule · outpatient · +11 other terms	17	$576	$579	$385	66%	—	$108 – $1.4k
25	Carefirst facility · fee schedule · both · +7 other terms	16	$145	$170	$82	48%	—	$97 – $410

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