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
HC TETROFOSMIN/MYOVIEW/SD
York, PA
See all hospitals reporting HCPCS A9502 →Price type
UPMC Memorial’s median price of $200 is 5% below the median hospital's median price ($211), higher than 48% of the 1,689 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: 6 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 medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $82 | $82 | — | — | — | $82 – $82 |
| 2 | Aetna medicare facility · fee schedule · outpatient | $87 | $87 | — | — | — | $87 – $87 |
| 3 | Highmark medicare facility · fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 4 | Cigna commercial facility · fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 5 | Blue Cross Blue Shield chip facility · fee schedule · outpatient | $141 | $141 | — | — | — | $141 – $141 |
| 6 | Blue Cross Blue Shield commercial facility · fee schedule · outpatient | $141 | $141 | — | — | — | $141 – $141 |
| 7 | Aetna aco facility · percent of total billed charges · outpatientfrom % of charges | $170 | $170 | — | — | — | $170 – $170 |
| 8 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $198 | $198 | — | — | — | $198 – $198 |
| 9 | Aetna aco facility · percent of total billed charges · inpatientfrom % of charges | $201 | $201 | — | — | — | $201 – $201 |
| 10 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $234 | $234 | — | — | — | $234 – $234 |
| 11 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $254 | $254 | — | — | — | $254 – $254 |
| 12 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges | $350 | $350 | — | — | — | $350 – $350 |
| 13 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges | $350 | $350 | — | — | — | $350 – $350 |
Last updated: Mar 6, 2026
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