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
TC99M TETROFOSMIN DXDOSE
Independence, MO
See all hospitals reporting HCPCS A9502 →Price type
Centerpoint Medical Center’s median price of $462 is 119% above the median hospital's median price ($211), higher than 85% of the 1,702 hospitals reporting HCPCS A9502. 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, 27 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 | UnitedHealthcare allpayerappendix fee schedule · outpatient | $193 | $193 | — | — | — | $193 – $193 |
| 2 | Anthem missouricaremgmcd percent of total billed charges · outpatientfrom % of charges | $203 | $203 | — | — | — | $203 – $203 |
| 3 | Ambetter commercial-exchange percent of total billed charges · outpatientfrom % of charges | $291 | $291 | — | — | — | $291 – $291 |
| 4 | Oscar hix percent of total billed charges · outpatientfrom % of charges | $297 | $297 | — | — | — | $297 – $297 |
| 5 | Humana aso percent of total billed charges · outpatientfrom % of charges | $330 | $330 | — | — | — | $330 – $330 |
| 6 | Humana epo percent of total billed charges · outpatientfrom % of charges | $330 | $330 | — | — | — | $330 – $330 |
| 7 | Humana hmo percent of total billed charges · outpatientfrom % of charges | $330 | $330 | — | — | — | $330 – $330 |
| 8 | Aetna familyhealthplanmcd percent of total billed charges · outpatientfrom % of charges | $344 | $344 | — | — | — | $344 – $344 |
| 9 | Blue Cross Blue Shield freedomnetworkselect percent of total billed charges · outpatientfrom % of charges | $344 | $344 | — | — | — | $344 – $344 |
| 10 | Cigna surefit/localplus percent of total billed charges · outpatientfrom % of charges | $388 | $388 | — | — | — | $388 – $388 |
| 11 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $393 | $393 | — | — | — | $393 – $393 |
| 12 | Humana pos percent of total billed charges · outpatientfrom % of charges | $415 | $415 | — | — | — | $415 – $415 |
| 13 | Humana ppo percent of total billed charges · outpatientfrom % of charges | $415 | $415 | — | — | — | $415 – $415 |
| 14 | Blue Cross Blue Shield freedomnetwork percent of total billed charges · outpatientfrom % of charges | $454 | $454 | — | — | — | $454 – $454 |
| 15 | Blue Cross Blue Shield pc percent of total billed charges · outpatientfrom % of charges | $454 | $454 | — | — | — | $454 – $454 |
| 16 | Cigna localkc percent of total billed charges · outpatientfrom % of charges | $462 | $462 | — | — | — | $462 – $462 |
| 17 | Blue Cross Blue Shield blue-care(hmo) percent of total billed charges · outpatientfrom % of charges | $469 | $469 | — | — | — | $469 – $469 |
| 18 | Blue Cross Blue Shield blueaccess percent of total billed charges · outpatientfrom % of charges | $469 | $469 | — | — | — | $469 – $469 |
| 19 | Blue Cross Blue Shield preferred-careblue(ppo) percent of total billed charges · outpatientfrom % of charges | $469 | $469 | — | — | — | $469 – $469 |
| 20 | Cigna comm percent of total billed charges · outpatientfrom % of charges | $577 | $577 | — | — | — | $577 – $577 |
| 21 | UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges | $704 | $704 | — | — | — | $704 – $704 |
| 22 | Blue Cross Blue Shield participating percent of total billed charges · outpatientfrom % of charges | $720 | $720 | — | — | — | $720 – $720 |
| 23 | Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges | $720 | $720 | — | — | — | $720 – $720 |
| 24 | MultiPlan primarynetwork percent of total billed charges · outpatientfrom % of charges | $829 | $829 | — | — | — | $829 – $829 |
| 25 | MultiPlan complimentarynetwork percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
Last updated: Mar 1, 2026
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