Technetium-99m disofenin diagnostic imaging agent at Samaritan Hospital

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

TC-99M DISOFENIN

Troy, NY

See all hospitals reporting HCPCS A9510 →

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Pricing by billing methodology

Price type

How this price compares nationally

Samaritan Hospital’s median price of $112 is 5% below the median hospital's median price ($118), higher than 48% of the 1,239 hospitals reporting HCPCS A9510. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9510 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 14 payers, 22 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 essential plan medicaid facility · percent of total billed charges · bothfrom % of charges	$82	$82	—	—	—	$82 – $82
2	UnitedHealthcare united healthcare medicaid harp chip facility · percent of total billed charges · bothfrom % of charges	$82	$82	—	—	—	$82 – $82
3	Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
4	Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
5	Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
6	Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
7	Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
8	Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
9	Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
10	Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
11	Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
12	Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
13	Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
14	Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$112	$112	—	—	—	$112 – $112
15	Aetna aetna facility · percent of total billed charges · bothfrom % of charges	$143	$143	—	—	—	$143 – $143
16	Medical Mutual aetna facility · percent of total billed charges · bothfrom % of charges	$143	$143	—	—	—	$143 – $143
17	First Health first health facility · percent of total billed charges · bothfrom % of charges	$163	$163	—	—	—	$163 – $163
18	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$173	$173	—	—	—	$173 – $173
19	MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges	$184	$184	—	—	—	$184 – $184
20	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$184	$184	—	—	—	$184 – $184
21	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$184	$184	—	—	—	$184 – $184
22	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$204	$204	—	—	—	$204 – $204

Last updated: Mar 31, 2026

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