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
HC A9569 MED: TECHNETIUM TC-99M EXAMETAZIME LABELED AUTOLOGOUS WHITE BLOOD CELLS, DX, PER STUDY DOSE
Orange, TX
See all hospitals reporting HCPCS A9569 →Price type
CHRISTUS Hospital - Orange’s median price of $1.1k is 34% below the median hospital's median price ($1.7k), higher than 27% 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: 12 payers, 30 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 chip km percent of total billed charges · outpatientfrom % of charges | $831 | $831 | — | — | — | $831 – $831 |
| 2 | UnitedHealthcare star kid km percent of total billed charges · outpatientfrom % of charges | $831 | $831 | — | — | — | $831 – $831 |
| 3 | UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges | $831 | $831 | — | — | — | $831 – $831 |
| 4 | UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges | $831 | $831 | — | — | — | $831 – $831 |
| 5 | UnitedHealthcare all payer fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 6 | UnitedHealthcare hix fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 7 | Aetna mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 8 | Bcbs Tx mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 9 | Humana gold choice mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 10 | Molina medicare adv mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 11 | UnitedHealthcare mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 12 | WellCare mm fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 13 | Devoted mm fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 14 | UnitedHealthcare hix percent of total billed charges · outpatientfrom % of charges | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 15 | Molina chip km percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 16 | Molina star km percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 17 | Molina star plus km percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 18 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 19 | Cigna new business percent of total billed charges · outpatientfrom % of charges | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 20 | Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 21 | Humana choicecare fee schedule · outpatient | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 22 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 23 | First Health ppo percent of total billed charges · outpatientfrom % of charges | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 24 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $5.7k | $5.7k | — | — | — | $5.7k – $5.7k |
| 25 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $5.8k | $5.8k | — | — | — | $5.8k – $5.8k |
Last updated: Jan 13, 2026
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