Technetium-99m tetrofosmin imaging agent at Wayne Memorial 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

HC TC99M TC TETROFOSMIN DX PSD MYO

Goldsboro, NC

See all hospitals reporting HCPCS A9502 →

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Pricing by billing methodology

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How this price compares nationally

Wayne Memorial Hospital’s median price of $117 is 45% below the median hospital's median price ($211), higher than 20% 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 Wayne Memorial Hospital

Negotiated rates from the hospital’s own file: 7 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	Amerihealth Caritas managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$41	$41	—	—	—	$41 – $41
2	UnitedHealthcare chip/medicaid facility · percent of total billed charges · outpatientfrom % of charges	$41	$41	—	—	—	$41 – $41
3	WellCare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$41	$41	—	—	—	$41 – $41
4	Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$48	$48	—	—	—	$48 – $48
5	Aetna north carolina preferred facility · percent of total billed charges · outpatientfrom % of charges	$117	$117	—	—	—	$117 – $117
6	Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges	$121	$121	—	—	—	$121 – $121
7	UnitedHealthcare individual exchange facility · percent of total billed charges · inpatientfrom % of charges	$122	$122	—	—	—	$122 – $122
8	UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges	$128	$128	—	—	—	$128 – $128
9	Blue Cross Blue Shield blue select/blue value/hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges	$129	$129	—	—	—	$129 – $129
10	Medcost commercial/ultra facility · percent of total billed charges · outpatientfrom % of charges	$134	$134	—	—	—	$134 – $134
11	Medcost commercial/ultra facility · percent of total billed charges · inpatientfrom % of charges	$135	$135	—	—	—	$135 – $135
12	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$142	$142	—	—	—	$142 – $142
13	Cigna commercial facility · fee schedule · outpatient	$196	$196	—	—	—	$196 – $196
14	UnitedHealthcare commercial facility · fee schedule · outpatient	$308	$308	—	—	—	$308 – $308
15	UnitedHealthcare individual exchange facility · fee schedule · outpatient	$308	$308	—	—	—	$308 – $308

Last updated: Jun 18, 2026

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