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
TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, AEROSOL, PER STUDY DOSE, UP TO 75 MILLICURIES
Custer, SD
See all hospitals reporting HCPCS A9567 →Price type
Monument Health Network Inc’s median price of $1.5k is 1041% above the median hospital's median price ($128), higher than 98% of the 1,475 hospitals reporting HCPCS A9567. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 10 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 uhc mcr adv percent of total billed charges · outpatientfrom % of charges | $407 | $407 | — | — | — | $407 – $407 |
| 2 | Medica medica mcr adv percent of total billed charges · outpatientfrom % of charges | $417 | $417 | — | — | — | $417 – $417 |
| 3 | Wellmark bcbs wellmark mcr adv percent of total billed charges · outpatientfrom % of charges | $417 | $417 | — | — | — | $417 – $417 |
| 4 | Medica medica mcaid percent of total billed charges · outpatientfrom % of charges | $542 | $542 | — | — | — | $542 – $542 |
| 5 | Wellmark bcbs wellmark - all other plans percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 6 | Aetna aetna - all plans percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 7 | MultiPlan multiplan/phcs - all plans percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 8 | Medica medica commercial - all other plans percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 9 | UnitedHealthcare uhc - all other plans percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 10 | Humana humana commercial - all plans percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
Last updated: Sep 1, 2026
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