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Technetium Tc-99m Labeled Autologous White Blood Cells

Utah 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?

$1,698

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $1,698 for this service. The price depends on where it is billed: about $1,698 from a physician practice, and about $1,862 from a hospital or other facility.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,698$1,698 to $1,738
FacilityA hospital or hospital-owned outpatient department$1,862$1,698 to $2,455

How much rates vary

Facilitymedian $1,862 · 10th to 90th $1,698 to $2,754Professionalmedian $1,698 · 10th to 90th $1,698 to $1,950
$50$100$200$500$1K$2Kfacility $1,862professional $1,698

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,698.24
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,698.24
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$1,737.80
Molina
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$1,698.24
Typical High
$1,905.46
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$1,698.24
Median
$2,137.96
Typical High
$3,019.95
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$2,630.27
Select Health
Setting
Facility
Modifier
None
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$1,949.84
United
Setting
Professional
Modifier
None
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,698.24

Where Utah 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.

Utah· 44th of 51

$1,698

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.