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Missouri rates for HCPCS A9571

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

Facilitymedian $5,248 · 10th–90th $4,074–$10,9650%20%10th90th$5,248Professionalmedian $4,169 · 10th–90th $3,802–$5,0120%50%10th90th$4,169$10.0$50.0$200.0$1.0K$5.0K

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 / $4,073.80 / $5,248.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $5,011.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $8,511.38 / $10,964.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $5,011.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $7,079.46 / $7,943.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $5,754.40 / $19,054.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,168.69 / $6,025.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $4,786.30 / $7,585.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $4,168.69 / $4,897.79