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Maine rates for HCPCS A9571

Indium In-111 labeled autologous platelets, diagnostic, per study dose

Facilitymedian $12,303 · 10th–90th $4,898–$12,8820%20%40%10th90th$12,303Professionalmedian $4,266 · 10th–90th $4,074–$4,2660%50%10th$4,266$5.0K$10.0K

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,265.80 / $4,265.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,882.50 / $12,882.50 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,265.80 / $4,265.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $12,302.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $5,128.61
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,265.80 / $4,265.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,265.80 / $5,888.44