Technetium-99m mebrofenin diagnostic 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

TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES

Payers reporting HCPCS A9537

Payer pricing summary

Low

$19

Average

$825

Median

$216

High

$11.5k

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +27 other terms	256	$134	$166	$147	89%	186–303	$1 – $3.5k
2	UnitedHealthcare fee schedule · outpatient · +30 other terms	478	$187	$216	$159	74%	84–219	$1 – $2.3k
3	Anthem fee schedule · outpatient · +23 other terms	109	$82	$116	$165	142%	73–262	$14 – $1.8k
4	Bcbs Wy other · both · +3 other terms	1	$195	$195	—	—	45	$195 – $195
5	Bcbs Al facility · other · outpatient · +1 other terms	5	$1.5k	$1.7k	$1.7k	99%	14–41	$35 – $5.0k
6	Medica fee schedule · outpatient · +16 other terms	33	$118	$125	$41	33%	7–70	$31 – $358
7	Molina fee schedule · outpatient · +27 other terms	31	$64	$94	$199	213%	3–30	$1 – $1.4k
8	Cigna fee schedule · outpatient · +21 other terms	265	$106	$175	$132	75%	2–20	$16 – $1.1k
9	Kaiser fee schedule · both · +16 other terms	49	$80	$77	$49	63%	2–20	$45 – $563
10	Bcbs Ar percent of total billed charges · bothfrom % of charges	1	$57	$57	—	—	2–20	$57 – $57
11	Bcbs Sc percent of total billed charges · bothfrom % of charges	1	$42	$42	—	—	2–20	$42 – $42
12	Caresource fee schedule · outpatient · +16 other terms	20	$70	$98	$92	94%	1–10	$1 – $473
13	Bcbs Ny percent of total billed charges · bothfrom % of charges	1	$464	$464	—	—	1–10	$464 – $464
14	Aetna fee schedule · outpatient · +30 other terms	135	$136	$189	$194	103%	—	$1 – $1.4k
15	Humana fee schedule · outpatient · +23 other terms	101	$164	$275	$250	91%	—	$1 – $1.4k
16	MultiPlan fee schedule · outpatient · +15 other terms	82	$163	$231	$278	120%	—	$19 – $1.7k
17	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +3 other terms	60	$223	$299	$226	76%	—	$19 – $1.1k
18	First Health fee schedule · inpatient · +13 other terms	31	$192	$333	$349	105%	—	$59 – $1.5k
19	Highmark facility · fee schedule · outpatient · +15 other terms	24	$195	$271	$198	73%	—	$57 – $848
20	Medicaid fee schedule · outpatient · +9 other terms	21	$236	$342	$401	117%	—	$1 – $1.5k
21	Phcs fee schedule · outpatient · +11 other terms	20	$133	$231	$198	86%	—	$104 – $715
22	Tricare facility · fee schedule · outpatient · +11 other terms	20	$262	$379	$266	70%	—	$69 – $987
23	WellCare professional · fee schedule · outpatient · +16 other terms	18	$69	$66	$10	15%	—	$8 – $70
24	Excellus facility · fee schedule · both · +7 other terms	17	$97	$74	$58	79%	—	$8 – $223
25	Premera facility · fee schedule · both · +8 other terms	17	$97	$90	$53	59%	—	$8 – $223

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