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Pennsylvania rates for HCPCS A9513

Lutetium Lu 177, dotatate, therapeutic, 1 mCi

Facilitymedian $724 · 10th–90th $380$158,4890%10%20%10th90th$724Professionalmedian $309 · 10th–90th $295$3720%50%10th90th$309$1.0$10.0$100.0$1.0K$10.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $724.44 / $158,489.32
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $309.03 / $363.08
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $380.19 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $1,202.26 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,023.29 / $1,071.52
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $512.86 / $851.14
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $309.03 / $309.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $331.13
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $269.15 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $338.84 / $398.11