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Technetium Tc-99m Teboroxime, Diagnostic

Wisconsin rates for HCPCS A9501

Technetium Tc-99m teboroxime, diagnostic, per study dose

Rates data updated July 2026.

How much does Technetium Tc-99m Teboroxime, Diagnostic cost?

$77.62

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $77.62 for this service. The price depends on where it is billed: about $77.62 from a physician practice, and about $77.62 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$77.62$77.62 to $77.62
FacilityA hospital or hospital-owned outpatient department$77.62$77.62 to $117

How much rates vary

Facilitymedian $78 · 10th to 90th $78 to $120Professionalmedian $78 · 10th to 90th $78 to $78
$100$200facility $78professional $78

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$120.23
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$323.59
Typical High
$338.84
Medica
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$120.23
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$54.95
Typical High
$85.11
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$120.23

Where Wisconsin sits

The same service costs 5.1 times more in New York than in Georgia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 38th of 51

$77.62

NY $288GA $56.23

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.