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
TC99 TETROFOSMIN DX P/STDY DSE
Pittsburgh, PA
See all hospitals reporting HCPCS A9502 →Price type
UPMC Mercy’s median price of $423 is 100% above the median hospital's median price ($211), higher than 82% of the 1,695 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: 5 payers, 25 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 | Highmark complete blue medicare advantage/freedom blue medicare advantage/security blue medicare advantage facility · fee schedule · outpatient | $119 | $119 | — | — | — | $119 – $119 |
| 2 | Aetna medicare facility · percent of total billed charges · outpatientfrom % of charges | $211 | $211 | — | — | — | $211 – $211 |
| 3 | Aetna neighborhood network facility · percent of total billed charges · outpatientfrom % of charges | $236 | $236 | — | — | — | $236 – $236 |
| 4 | Aetna home depot employer group facility · percent of total billed charges · outpatientfrom % of charges | $257 | $257 | — | — | — | $257 – $257 |
| 5 | Aetna neighborhood network facility · percent of total billed charges · inpatientfrom % of charges | $259 | $259 | — | — | — | $259 – $259 |
| 6 | Aetna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges | $262 | $262 | — | — | — | $262 – $262 |
| 7 | Aetna home depot employer group facility · percent of total billed charges · inpatientfrom % of charges | $281 | $281 | — | — | — | $281 – $281 |
| 8 | Aetna nbr aso/fi facility · percent of total billed charges · inpatientfrom % of charges | $287 | $287 | — | — | — | $287 – $287 |
| 9 | Cigna new business aso facility · percent of total billed charges · inpatientfrom % of charges | $287 | $287 | — | — | — | $287 – $287 |
| 10 | Aetna ebr fi facility · percent of total billed charges · inpatientfrom % of charges | $321 | $321 | — | — | — | $321 – $321 |
| 11 | Aetna ebr fi facility · percent of total billed charges · outpatientfrom % of charges | $321 | $321 | — | — | — | $321 – $321 |
| 12 | Aetna ebr aso facility · percent of total billed charges · inpatientfrom % of charges | $338 | $338 | — | — | — | $338 – $338 |
| 13 | Aetna ebr aso facility · percent of total billed charges · outpatientfrom % of charges | $338 | $338 | — | — | — | $338 – $338 |
| 14 | Highmark managed care - social mission facility · fee schedule · outpatient | $340 | $340 | — | — | — | $340 – $340 |
| 15 | Cigna new business aso facility · percent of total billed charges · outpatientfrom % of charges | $346 | $346 | — | — | — | $346 – $346 |
| 16 | Highmark commercial - social mission indemnity facility · fee schedule · outpatient | $349 | $349 | — | — | — | $349 – $349 |
| 17 | First Health commercial facility · percent of total billed charges · inpatientfrom % of charges | $372 | $372 | — | — | — | $372 – $372 |
| 18 | First Health commercial facility · percent of total billed charges · outpatientfrom % of charges | $372 | $372 | — | — | — | $372 – $372 |
| 19 | Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges | $423 | $423 | $85 | 20% | — | $338 – $507 |
| 20 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $423 | $423 | $85 | 20% | — | $338 – $507 |
| 21 | Highmark medicare facility · percent of total billed charges · outpatientfrom % of charges | $423 | $423 | — | — | — | $423 – $423 |
| 22 | Highmark managed care facility · fee schedule · outpatient | $455 | $455 | — | — | — | $455 – $455 |
| 23 | Highmark commercial - indemnity facility · fee schedule · outpatient | $468 | $468 | — | — | — | $468 – $468 |
| 24 | MultiPlan ppo (inc. auto and worker's compensation) facility · percent of total billed charges · inpatientfrom % of charges | $761 | $761 | — | — | — | $761 – $761 |
| 25 | MultiPlan ppo (inc. auto and worker's compensation) facility · percent of total billed charges · outpatientfrom % of charges | $761 | $761 | — | — | — | $761 – $761 |
Last updated: Mar 6, 2026
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