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Technetium Tc-99m Labeled Autologous White Blood Cells

Indiana rates for HCPCS A9569

Technetium Tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose

Rates data updated October 2026.

How much does Technetium Tc-99m Labeled Autologous White Blood Cells cost?

$1,660

Typical negotiated rate. In Indiana, October 2026.

Insurers have agreed to pay about $1,660 for this service. The price depends on where it is billed: about $1,514 from a physician practice, and about $1,862 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,514$102 to $1,738
FacilityA hospital or hospital-owned outpatient department$1,862$1,175 to $2,754

How much rates vary

Facilitymedian $1,862 · 10th to 90th $933 to $3,467Professionalmedian $1,514 · 10th to 90th $102 to $2,754
$100$200$500$1K$2K$5Kfacility $1,862professional $1,514

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,737.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,698.24
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$933.25
Median
$1,862.09
Typical High
$3,467.37
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$123.03
Typical High
$2,041.74
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,905.46
Median
$4,365.16
Typical High
$4,786.30
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$4,786.30
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$2,089.30
Typical High
$2,754.23
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None
Typical Low
$1,258.93
Median
$1,548.82
Typical High
$3,981.07
United
Setting
Professional
Modifier
None
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$3,467.37

Where Indiana sits

The same service costs 1.7 times more in Alaska than in Kentucky. 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.

Indiana· 50th of 51

$1,660

AK $2,754KY $1,660

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.