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
VIENNA, VA
See all hospitals reporting HCPCS A9502 →Price type
Reston Hospital Center’s median price of $337 is 60% above the median hospital's median price ($211), higher than 73% 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: 4 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 | Cigna ifp fee schedule · outpatient | $79 | $79 | — | — | — | $79 – $79 |
| 2 | Aetna mgmcr percent of total billed charges · outpatientfrom % of charges | $124 | $124 | — | — | — | $124 – $124 |
| 3 | Cigna hmo fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 4 | Cigna ppo fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 5 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $232 | $232 | — | — | — | $232 – $232 |
| 6 | Aetna broad percent of total billed charges · outpatientfrom % of charges | $274 | $274 | — | — | — | $274 – $274 |
| 7 | UnitedHealthcare allpayerappendix fee schedule · outpatient | $310 | $310 | — | — | — | $310 – $310 |
| 8 | Carefirst hmo percent of total billed charges · outpatientfrom % of charges | $365 | $365 | — | — | — | $365 – $365 |
| 9 | Carefirst rpn percent of total billed charges · outpatientfrom % of charges | $365 | $365 | — | — | — | $365 – $365 |
| 10 | UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges | $373 | $373 | — | — | — | $373 – $373 |
Last updated: Mar 1, 2026
See Technetium-99m tetrofosmin imaging agent pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.