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
KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG
Madras, OR
See all hospitals reporting HCPCS A9567 →Price type
St. Charles Madras’s median price of $197 is 54% above the median hospital's median price ($128), higher than 63% 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: 11 payers, 15 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 | Aetna medicare percent of total billed charges · bothfrom % of charges | $68 | $68 | — | — | — | $68 – $68 |
| 2 | Cigna medicare percent of total billed charges · bothfrom % of charges | $68 | $68 | — | — | — | $68 – $68 |
| 3 | Devoted medicare percent of total billed charges · bothfrom % of charges | $68 | $68 | — | — | — | $68 – $68 |
| 4 | Humana medicare percent of total billed charges · bothfrom % of charges | $68 | $68 | — | — | — | $68 – $68 |
| 5 | Kaiser medicare percent of total billed charges · bothfrom % of charges | $68 | $68 | — | — | — | $68 – $68 |
| 6 | Medicare medicare percent of total billed charges · bothfrom % of charges | $68 | $68 | — | — | — | $68 – $68 |
| 7 | UnitedHealthcare medicare percent of total billed charges · bothfrom % of charges | $68 | $68 | — | — | — | $68 – $68 |
| 8 | WellCare medicare percent of total billed charges · bothfrom % of charges | $68 | $68 | — | — | — | $68 – $68 |
| 9 | Blue Cross Blue Shield blue cross medicare percent of total billed charges · bothfrom % of charges | $74 | $74 | — | — | — | $74 – $74 |
| 10 | Tricare tricare percent of total billed charges · bothfrom % of charges | $88 | $88 | — | — | — | $88 – $88 |
| 11 | Kaiser oregon medicaid cco percent of total billed charges · bothfrom % of charges | $116 | $116 | — | — | — | $116 – $116 |
| 12 | Cigna cigna percent of total billed charges · bothfrom % of charges | $178 | $178 | — | — | — | $178 – $178 |
| 13 | Kaiser first choice health network percent of total billed charges · bothfrom % of charges | $244 | $244 | — | — | — | $244 – $244 |
| 14 | Aetna aetna percent of total billed charges · bothfrom % of charges | $245 | $245 | — | — | — | $245 – $245 |
| 15 | First Health first health percent of total billed charges · bothfrom % of charges | $276 | $276 | — | — | — | $276 – $276 |
Last updated: Apr 1, 2026
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