A9500

Technetium tc-99m sestamibi, diagnostic, per study dose

Medicare pricing data for 6,855 providers across 51 states

🤖AI Overview

Prices vary significantly by location — from $45 in South Dakota to $225 in New Mexico. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Technetium tc-99m sestamibi, diagnostic, per study dose (HCPCS code A9500) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $108.35, but hospitals typically charge $346.50 — a 3.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$21.67

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $108.35, your out-of-pocket cost would be approximately $21.67. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$108.35
Average Hospital Charge
$346.50
Markup Ratio
3.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$346.50
Medicare Allowed$108.35
Medicare Payment$86.07

Hospitals charge 3.2x more than what Medicare allows for this procedure. Medicare actually pays $86.07 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Mexico$225$31611398+107.6%
Wyoming$157$283151,397+45.2%
Idaho$150$234161,014+38.2%
Pennsylvania$148$4181586,051+36.8%
Kansas$147$313795,083+36.1%
Nebraska$145$289424,272+33.4%
Michigan$143$32118620,001+32.2%
Indiana$142$569605,900+31.1%
Missouri$141$425934,878+30.3%
New Jersey$138$46332017,689+27.5%
Maryland$135$38513912,089+24.3%
Iowa$131$224534,768+21.2%
Minnesota$127$334921,481+17.4%
Mississippi$126$742501,795+16.5%
Texas$122$47161230,845+12.3%
District of Columbia$121$29620756+12.1%
Illinois$119$43218218,962+9.5%
New Hampshire$117$4254309+8.0%
Rhode Island$116$199191,704+7.0%
Massachusetts$114$40410013,446+5.6%
Colorado$114$40946937+5.2%
Vermont$114$3653330+5.0%
Alaska$113$240171,649+4.6%
Puerto Rico$113$14716856+4.4%
Virginia$112$27815416,424+3.7%
New York$112$41057169,660+3.4%
Florida$110$280957125,148+1.7%
South Carolina$109$34216624,502+0.5%
Delaware$108$411293,883+0.1%
Arkansas$108$507402,632+0.1%
Tennessee$107$2691617,300-0.9%
Alabama$107$20914513,171-0.9%
Georgia$107$3391229,676-1.2%
Connecticut$106$2791048,603-1.9%
North Carolina$106$32334728,543-2.4%
West Virginia$106$371234,981-2.5%
Louisiana$106$4161378,112-2.6%
Hawaii$105$2545620-2.8%
Wisconsin$99$3231454,071-8.2%
Oklahoma$95$210221,428-12.2%
California$95$37562180,489-12.6%
North Dakota$88$3573142-18.7%
Arizona$81$32624634,103-25.4%
Oregon$69$256401,872-36.0%
Montana$66$387489-38.9%
Utah$60$335192,172-44.8%
Nevada$53$21711413,047-50.7%
Kentucky$50$214202,240-54.0%
Washington$48$416922,706-55.7%
Ohio$46$26222211,916-58.0%
South Dakota$45$19211327-58.8%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber