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Wisconsin rates for HCPCS A9570

Indium In-111 labeled autologous white blood cells, diagnostic, per study dose

Facilitymedian $4,898 · 10th–90th $2,042–$10,9650%20%10th90th$4,898Professionalmedian $4,169 · 10th–90th $4,074–$9,7720%50%10th90th$4,169$100.0$500.0$2.0K$10.0K$50.0K

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
$4,073.80 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,168.69 / $4,265.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,398.83 / $2,454.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,168.69 / $12,022.64
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $10,964.78 / $17,782.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $6,456.54 / $7,762.47
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,265.80 / $5,370.32
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $4,168.69
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $4,073.80 / $5,370.32
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $8,912.51
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,365.16
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,165.95 / $6,165.95
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $11,220.18 / $16,982.44
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $15,135.61
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $5,370.32 / $22,908.68
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $2,398.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $5,495.41