Code: A9500

Description:
Description: Technetium tc-99m sestamibi, diagnostic, per study dose
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Other Descriptions:
HC TECHNETIUM TC-99M SESTAMIBI DX UP TO 40 MCI
RP SESTAMIBI DOSE UP TO 40MCI
TECHNETIUM TC 99M SESTAMIBI - CARDIOLITE
TC99M SESTABIBI UP TO 40MCI
TC99M SESTAMBI
HCHG CVMC TC99M TETROFOSMIN
RX DX Cardiolite per Dose
Tc99m Sestamibi Per Dose
Related codes:
Code: A9501
Description: Technetium tc-99m teboroxime, diagnostic, per study dose
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Code: A9502
TC99M TETROFOSMIN DXDOSE
Code: A9503
TC99M MEDRONATE DX 30MCI
Code: A9504
TC99M APCITIDE DX 20MCI
Code: A9505
TL201 THALLOUS CL DX MCI
Code: A9507
IN111 CAPRO PEN DX 10MCI
Code: A9508
I131 IOBENGUAN DX 0.5MCI
Code: A9509
I123 SODIUM IOD DX 1 MCI
Wisconsin
Hospital Address Code Price Last Updated
River Falls Area Hospital , River Falls A9500 $45 [source] 4 years ago
Ascension Calumet Hospital 614 Memorial Dr, Chilton A9500 $170 [source] 4 years ago
Essentia Health St. Mary's Hospital-Superior 3500 Tower Ave, Superior A9500 $299 [source] 4 years ago
Tomah Memorial Hospital 501 Gopher Dr, Tomah A9500 $356 [source] 4 years ago
Aspirus Medford Hospital 135 S Gibson St, Medford A9500 $486 [source] 4 years ago
Aspirus Stevens Point Hospital 5409 Vern Holmes Dr, A9500 $486 [source] 4 years ago
Aspirus Riverview Hospital 410 Dewey St, Wisconsin Rapids A9500 $486 [source] 4 years ago
Aspirus Langlade Hospital 110 E 5Th Ave, Antigo A9500 $486 [source] 4 years ago
Aspirus Wausau Hospital 333 Pine Ridge Blvd, Wausau A9500 $486 [source] 4 years ago
Aurora Sinai Medical Center 945 N 12Th St, Milwaukee A9500 $510 [source] 4 years ago
Aurora Baycare 1160 Kepler Dr, Green Bay A9500 $510 [source] 4 years ago
Aurora Medical Center Of Manitowoc County 5000 Memorial Dr, Two Rivers A9500 $510 [source] 4 years ago
Aurora Medical Center Burlington 252 Mchenry St, Burlington A9500 $510 [source] 4 years ago
Aurora Medical Center Summit 36500 Aurora Dr, Oconomowoc A9500 $510 [source] 4 years ago
Aurora Medical Center Bay Area 3003 University Dr, Marinette A9500 $510 [source] 4 years ago
Aurora Lakeland Medical Center W3930 County Road Nn, Elkhorn A9500 $510 [source] 4 years ago
Aurora Sheboygan Memorial Medical Center 2629 N 7Th St, Sheboygan A9500 $510 [source] 4 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee A9500 $510 [source] 4 years ago
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy A9500 $510 [source] 4 years ago
Aurora West Allis Medical Center 8901 W Lincoln Ave, Milwaukee A9500 $510 [source] 4 years ago
Aurora Medical Center Of Washington County 1032 E Sumner St, Hartford A9500 $510 [source] 4 years ago
Aurora Medical Center Of Oshkosh 855 N Westhaven Dr, Oshkosh A9500 $510 [source] 4 years ago
Aurora Medical Center Grafton 975 Port Washington Road, Grafton A9500 $510 [source] 4 years ago
Aurora Medical Center Kenosha 10400 75Th St, Kenosha A9500 $510 [source] 4 years ago
Aspirus Divine Savior Hospital 2817 New Pinery Rd, Portage A9500 $537 [source] 4 years ago
Chippewa Valley Hospital & Oakview Care Center, Inc. 1220 3Rd Ave W, Durand A9500 $682 [source] 4 years ago
Prairie Ridge Health 1515 Park Ave, Columbus A9500 $735 [source] 4 years ago
Upland Hills Health 800 Compassion Way, Dodgeville A9500 $891 [source] 4 years ago
Watertown Regional Medical Center 125 Hospital Drive, Watertown A9500 $1,274 [source] 4 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.