Technetium-99m tetrofosmin imaging agent at Ukiah Adventist 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

TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, PER STUDY DOSE

Ukiah, CA

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How this price compares nationally

Ukiah Adventist Hospital’s median price of $430 is 103% above the median hospital's median price ($211), higher than 84% of the 1,702 hospitals reporting HCPCS A9502. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9502 at Ukiah Adventist Hospital

Negotiated rates from the hospital’s own file: 7 payers, 13 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	Blue Cross Blue Shield blue shield epn-all other plans percent of total billed charges · outpatientfrom % of charges	$187	$187	$106	57%	—	$81 – $294
2	Blue Cross Blue Shield blue shield non-epn percent of total billed charges · outpatientfrom % of charges	$190	$190	$108	57%	—	$82 – $298
3	UnitedHealthcare uhc all payer-all other plans fee schedule · outpatient	$318	$318	—	—	—	$318 – $318
4	Cigna cigna-all plans percent of total billed charges · outpatientfrom % of charges	$383	$383	$218	57%	—	$165 – $601
5	Kaiser kaiser-all other plans percent of total billed charges · outpatientfrom % of charges	$393	$393	$224	57%	—	$170 – $617
6	MultiPlan phcs multiplan-all plans percent of total billed charges · outpatientfrom % of charges	$393	$393	$224	57%	—	$170 – $617
7	UnitedHealthcare uhc jll csp 1/1/25 fee schedule · outpatient	$430	$430	—	—	—	$430 – $430
8	Kaiser kaiser medi-cal fee schedule · outpatient	$492	$492	$280	57%	—	$212 – $771
9	Medicaid medi-cal fee schedule · outpatient	$492	$492	$280	57%	—	$212 – $771
10	Blue Cross Blue Shield blue cross exchange fee schedule · outpatient	$522	$522	—	—	—	$522 – $522
11	Blue Cross Blue Shield blue cross non-mcs fee schedule · outpatient	$580	$580	—	—	—	$580 – $580
12	Aetna aetna-all plans fee schedule · outpatient	$640	$640	—	—	—	$640 – $640
13	Blue Cross Blue Shield blue cross mcs-all other plans fee schedule · outpatient	$696	$696	—	—	—	$696 – $696

Last updated: May 24, 2026

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