Technetium-99m pentetate 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 PENTETATE DTPA

Troy, NY

See all hospitals reporting HCPCS A9539 →

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Pricing by billing methodology

Price type

How this price compares nationally

Samaritan Hospital’s median price of $207 is 71% above the median hospital's median price ($121), higher than 68% of the 1,794 hospitals reporting HCPCS A9539. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9539 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	$151	$151	—	—	—	$151 – $151
2	UnitedHealthcare united healthcare medicaid harp chip facility · percent of total billed charges · bothfrom % of charges	$151	$151	—	—	—	$151 – $151
3	Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
4	Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
5	Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
6	Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
7	Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
8	Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
9	Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
10	Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
11	Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
12	Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
13	Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
14	Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$207	$207	—	—	—	$207 – $207
15	Aetna aetna facility · percent of total billed charges · bothfrom % of charges	$263	$263	—	—	—	$263 – $263
16	Medical Mutual aetna facility · percent of total billed charges · bothfrom % of charges	$263	$263	—	—	—	$263 – $263
17	First Health first health facility · percent of total billed charges · bothfrom % of charges	$301	$301	—	—	—	$301 – $301
18	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$320	$320	—	—	—	$320 – $320
19	MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges	$339	$339	—	—	—	$339 – $339
20	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$339	$339	—	—	—	$339 – $339
21	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$339	$339	—	—	—	$339 – $339
22	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$376	$376	—	—	—	$376 – $376

Last updated: Mar 31, 2026

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