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Technetium Tc-99m Labeled Autologous White Blood Cells

New Hampshire rates for HCPCS A9569

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

Rates data updated July 2026.

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

$1,738

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $1,738 for this service. The price depends on where it is billed: about $1,738 from a physician practice, and about $2,754 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$1,738$1,738 to $1,738
FacilityA hospital or hospital-owned outpatient department$2,754$1,738 to $3,715

How much rates vary

Facilitymedian $2,754 · 10th to 90th $1,380 to $4,677Professionalmedian $1,738 · 10th to 90th $1,738 to $3,020
$1.0K$2.0K$5.0Kfacility $2,754professional $1,738

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$2,089.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$2,089.30
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$3,235.94
Typical High
$4,677.35
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,698.24
Median
$1,737.80
Typical High
$1,995.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$3,467.37
Typical High
$4,786.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$1,737.80
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$3,311.31
United
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$1,548.82
Typical High
$1,548.82
United
Setting
Professional
Modifier
Global
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,737.80

Where New Hampshire sits

The same service costs 2.4 times more in Alaska than in Minnesota. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

New Hampshire $1,738 · 17th of 51
AK $2,754MN $1,148

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.