Code: A9539

Description:
Description: Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Other Descriptions:
RP DTPA
HC RP DTPA
TECHNETIUM TC-99M PENTETATE DX UP TO 25 MCI
T99 PENTETATE
PENTETATE
RX DX 99MTC DTPA per Dose
Tc99m Pentetate<25mci
Related codes:
Code: A9530
I131 SOD IOD SOL TX MCI
Code: A9531
I131 SODIUM IOD DX UCI
Code: A9532
Description: Iodine i-125 serum albumin, diagnostic, per 5 microcuries
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Code: A9533
SPL RADOPHRM DX IMAG AGT I-131 TOSITUMOMAB-MCI
Code: A9534
SPL RADOPHRM TX IMAG AGT I-131 TOSITUMOMAB-MCI
Code: A9535
INJECTION METHYLENE BLUE 1 ML
Code: A9536
TC99M DEPREOTID DX 35MCI
Code: A9537
TC99M MEBROFEN DX 15MCI
Code: A9538
TC99M PYROPHOS DX 25MCI
Michigan
Hospital Address Code Price Last Updated
Mclaren Caro Region 401 N Hooper St, Caro A9539 $60 [source] 4 years ago
St. John Macomb Oakland Hospital-Warren Campus 11800 E 12 Mile Rd, Warren A9539 $72 [source] 4 years ago
William Beaumont Hospital 3555 W 13 Mile Rd, Royal Oak A9539 $74 [source] 4 years ago
Providence Hospital And Medical Centers 16001 W 9 Mile Rd, Southfield A9539 $74 [source] 4 years ago
St. John Providence 28000 Dequindre Rd, Warren A9539 $78 [source] 4 years ago
Ascension Providence Rochester Hospital 1101 W University Dr, Rochester A9539 $79 [source] 4 years ago
Mclaren Lapeer Region 1375 N Main St, Lapeer A9539 $83 [source] 4 years ago
Mclaren Northern Michigan 416 Connable Ave, Petoskey A9539 $89 [source] 4 years ago
William Beaumont Hospital 468 Cadieux Rd, Grosse Pointe A9539 $109 [source] 4 years ago
Aspirus Ironwood Hospital N10565 Grandview Ln, Ironwood A9539 $128 [source] 4 years ago
Mclaren Macomb 1000 Harrington St, Mount Clemens A9539 $152 [source] 4 years ago
Karmanos Cancer Institute 4100 John R St, Detroit A9539 $156 [source] 4 years ago
Dmc Children's Hospital Of Michigan 3901 Beaubien Blvd., Detroit A9539 $158 [source] 4 years ago
Mclaren Oakland 50 N Perry St, Pontiac A9539 $158 [source] 4 years ago
Mclaren Bay Region 1900 Columbus Ave, Bay City A9539 $163 [source] 4 years ago
Mclaren Bay Special Care Hospital 3250 E Midland Rd Suite 1, Bay City A9539 $163 [source] 4 years ago
Oakwood Healthcare Inc Beaumont Service Center, A9539 $251 [source] 4 years ago
William Beaumont Hospital 18181 Oakwood Blvd, Dearborn A9539 $251 [source] 4 years ago
Oakwood Healthcare, Inc. 18101 Oakwood Blvd, Dearborn A9539 $251 [source] 4 years ago
Oakwood Health Promotions, Inc. 16391 Rotunda Dr, Dearborn A9539 $251 [source] 4 years ago
Oakwood Healthcare, Inc. 33155 Annapolis St, Wayne A9539 $251 [source] 4 years ago
Oakwood Healthcare, Inc. 5450 Fort St, Trenton A9539 $251 [source] 4 years ago
Oakwood Healthcare, Inc. 10000 Telegraph Rd, Taylor A9539 $251 [source] 4 years ago
Mclaren Flint 401 S Ballenger Hwy, Flint A9539 $301 [source] 4 years ago
Midmichigan Medical Center Gladwin , Gladwin A9539 $322 [source] 4 years ago
Mclaren Greater Lansing 401 W Greenlawn Ave, Lansing A9539 $356 [source] 4 years ago
Beaumont Ashn, Llc 1919 Technology Dr Ste B, Troy A9539 $502 [source] 4 years ago
Beaumont Orthopaedic Center 3535 W 13 Mile Road, Royal Oak A9539 $502 [source] 4 years ago
William Beaumont Hospital 1026 Eleven Mile Road, Royal Oak A9539 $502 [source] 4 years ago
William Beaumont Hospital 3601 W 13 Mile Rd, Royal Oak A9539 $502 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre, Troy A9539 $502 [source] 4 years ago
Beaumont Health System 3601 W. 13 Mile Rd, Royal Oak A9539 $502 [source] 4 years ago
William Beaumont Hospital 5150 Coolidge Hwy, Royal Oak A9539 $502 [source] 4 years ago
Botsford Continuing Care Corporation 21450 Archwood Cir, Farmington A9539 $502 [source] 4 years ago
Botsford General Hospital 28050 Grand River Ave, Farmington A9539 $502 [source] 4 years ago
William Beaumont Hospital 4949 Coolidge Hwy, Royal Oak A9539 $502 [source] 4 years ago
William Beaumont Hospital 3535 W 13 Mile Rd, Royal Oak A9539 $502 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre Rd, Troy A9539 $502 [source] 4 years ago
Beaumont Special Radiological Procedures 3601 W Thirteen Mile Rd, Royal Oak A9539 $502 [source] 4 years ago
Up Health System – Marquette 580 West College Avenue, Marquette A9539 $572 [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 §180.