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
tc-99m-exametazime wbc per 30 millicurie
Boulder, CO
See all hospitals reporting HCPCS A9569 →Price type
Boulder Community Health’s median price of $3.8k is 123% above the median hospital's median price ($1.7k), higher than 86% of the 1,618 hospitals reporting HCPCS A9569. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 29 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna medicare advantage facility · case rate · outpatient | $934 | $934 | — | — | — | $934 – $934 |
| 2 | Anthem medicare advantage facility · case rate · outpatient | $934 | $934 | — | — | — | $934 – $934 |
| 3 | Humana medicare advantage facility · case rate · outpatient | $953 | $953 | — | — | — | $953 – $953 |
| 4 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $953 | $953 | — | — | — | $953 – $953 |
| 5 | Kaiser medicare advantage facility · case rate · outpatient | $957 | $957 | $5 | 0% | — | $953 – $962 |
| 6 | Devoted medicare advantage facility · case rate · outpatient | $962 | $962 | — | — | — | $962 – $962 |
| 7 | UnitedHealthcare medicare advantage professional · fee schedule · both | $1.3k | $1.3k | $390 | 29% | — | $934 – $1.7k |
| 8 | Anthem commercial professional · fee schedule · both | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 9 | Anthem managed care professional · fee schedule · both | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 10 | Aetna medicare advantage professional · fee schedule · both | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 11 | UnitedHealthcare commercial professional · fee schedule · both | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 12 | Cigna commercial facility · fee schedule · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 13 | Cigna commercial professional · fee schedule · both | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 14 | Kaiser commercial facility · case rate · outpatient | $2.0k | $2.0k | $247 | 12% | — | $1.8k – $2.3k |
| 15 | Humana medicare advantage professional · fee schedule · both | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 16 | Kaiser managed care facility · case rate · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 17 | Aetna commercial professional · fee schedule · both | $2.4k | $2.4k | $724 | 31% | — | $1.6k – $3.1k |
| 18 | Anthem commercial facility · percent of total billed charges · outpatientfrom % of charges | $3.6k | $4.2k | $1.3k | 30% | — | $2.9k – $6.9k |
| 19 | Anthem managed care facility · percent of total billed charges · outpatientfrom % of charges | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 20 | Devoted medicare advantage facility · percent of total billed charges · inpatientfrom % of charges | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 21 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $3.3k | $5.1k | $3.0k | 60% | — | $2.6k – $9.3k |
| 22 | Anthem commercial facility · percent of total billed charges · inpatientfrom % of charges | $6.7k | $6.7k | — | — | — | $6.7k – $6.7k |
| 23 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $7.5k | $7.5k | — | — | — | $7.5k – $7.5k |
| 24 | MultiPlan commercial facility · percent of total billed charges · inpatientfrom % of charges | $8.1k | $8.1k | — | — | — | $8.1k – $8.1k |
| 25 | Phcs commercial facility · percent of total billed charges · inpatientfrom % of charges | $8.1k | $8.1k | — | — | — | $8.1k – $8.1k |
Last updated: Sep 16, 2026
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