Technetium-99m labeled white blood cell scan agent at Mayo Clinic

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.

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Provider: anthropic
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Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

KIT FOR PREPARATION OF TC-99M-EXAMETAZIME WBC 0.5 MG INTRAVENOUS KIT

Rochester, MN

See all hospitals reporting HCPCS A9569 →

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How this price compares nationally

Mayo Clinic’s median price of $214 is 88% below the median hospital's median price ($1.7k), higher than 2% of the 1,618 hospitals reporting HCPCS A9569. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9569 at Mayo Clinic

Negotiated rates from the hospital’s own file: 18 payers, 72 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	Blue Cross Blue Shield medicaid base apr drg only [1276] facility · percent of total billed charges · bothfrom % of charges	$47	$47	—	—	—	$47 – $47
2	Blue Cross Blue Shield medicaid base apr drg only [1277] facility · percent of total billed charges · bothfrom % of charges	$47	$47	—	—	—	$47 – $47
3	Healthpartners medicaid cah healthpartners [1174] facility · percent of total billed charges · bothfrom % of charges	$47	$47	—	—	—	$47 – $47
4	Molina medicaid base apr drg only [1276] facility · percent of total billed charges · bothfrom % of charges	$47	$47	—	—	—	$47 – $47
5	Ucare medicaid base apr drg only [1276] facility · percent of total billed charges · bothfrom % of charges	$47	$47	—	—	—	$47 – $47
6	Ucare pps medicaid ucare [1184] facility · percent of total billed charges · bothfrom % of charges	$47	$47	—	—	—	$47 – $47
7	UnitedHealthcare medicaid base apr drg only [1276] facility · percent of total billed charges · bothfrom % of charges	$47	$47	—	—	—	$47 – $47
8	Medica medica medicaid [1244] facility · percent of total billed charges · bothfrom % of charges	$110	$110	—	—	—	$110 – $110
9	Medica medica medicare advantage plan msho msc+ cap [167] facility · percent of total billed charges · bothfrom % of charges	$113	$113	—	—	—	$113 – $113
10	Medica medicaid medica choice care msc+ [1175] facility · percent of total billed charges · bothfrom % of charges	$113	$113	—	—	—	$113 – $113
11	Optum medica ma medicare advantage plan behavioral health [1350] facility · percent of total billed charges · bothfrom % of charges	$137	$137	—	—	—	$137 – $137
12	Blue Cross Blue Shield blue cross blue shield aco [851] facility · percent of total billed charges · bothfrom % of charges	$198	$198	—	—	—	$198 – $198
13	Ucare ucare ifp [1108] facility · percent of total billed charges · bothfrom % of charges	$198	$198	—	—	—	$198 – $198
14	Blue Cross Blue Shield blue cross blue shield fep [874] facility · percent of total billed charges · bothfrom % of charges	$199	$199	—	—	—	$199 – $199
15	Anthem blue cross blue shield by payor [14] facility · percent of total billed charges · bothfrom % of charges	$203	$203	—	—	—	$203 – $203
16	Blue Cross Blue Shield blue cross blue shield by payor [14] facility · percent of total billed charges · bothfrom % of charges	$203	$203	—	—	—	$203 – $203
17	Blue Cross Blue Shield complex care complex and cancer care [806] facility · percent of total billed charges · bothfrom % of charges	$203	$203	—	—	—	$203 – $203
18	Blue Cross Blue Shield transplant bcbs [1140] facility · percent of total billed charges · bothfrom % of charges	$203	$203	—	—	—	$203 – $203
19	Healthpartners complex care complex and cancer care [806] facility · percent of total billed charges · bothfrom % of charges	$203	$203	—	—	—	$203 – $203
20	Medica az medica non mayo employees group [754] facility · percent of total billed charges · bothfrom % of charges	$203	$203	—	—	—	$203 – $203
21	Medica by plan [76] facility · percent of total billed charges · bothfrom % of charges	$203	$203	—	—	—	$203 – $203
22	Medica deanhp by medica west mc hmo 90 pct [1349] facility · percent of total billed charges · bothfrom % of charges	$203	$203	—	—	—	$203 – $203
23	Healthpartners transplant [692] facility · percent of total billed charges · bothfrom % of charges	$205	$205	—	—	—	$205 – $205
24	Optum united healthcare [1041] facility · percent of total billed charges · bothfrom % of charges	$205	$205	—	—	—	$205 – $205
25	UnitedHealthcare united healthcare [1041] facility · percent of total billed charges · bothfrom % of charges	$205	$205	—	—	—	$205 – $205

Page 1 of 3 · 72 rates

Last updated: Aug 14, 2026

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