go back

Indium In-111 Labeled Autologous Platelets, Diagnostic

Montana rates for HCPCS A9571

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

Rates data updated October 2026.

How much does Indium In-111 Labeled Autologous Platelets, Diagnostic cost?

$5,248

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $5,248 for this service. The price depends on where it is billed: about $4,266 from a physician practice, and about $8,128 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$4,266$3,890 to $5,370
FacilityA hospital or hospital-owned outpatient department$8,128$6,026 to $8,318

How much rates vary

Facilitymedian $8,128 · 10th to 90th $4,786 to $11,482Professionalmedian $4,266 · 10th to 90th $79 to $6,607
$100$500$2K$10Kfacility $8,128professional $4,266

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69
Cigna
Setting
Facility
Modifier
None
Typical Low
$6,456.54
Median
$6,606.93
Typical High
$24,547.09
Cigna
Setting
Professional
Modifier
None
Typical Low
$4,265.80
Median
$4,265.80
Typical High
$6,606.93
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$4,786.30
Median
$8,128.31
Typical High
$8,912.51
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$4,786.30
Median
$5,248.07
Typical High
$8,709.64
Providence
Setting
Facility
Modifier
None
Typical Low
$6,456.54
Median
$6,606.93
Typical High
$24,547.09
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$5,128.61
Typical High
$6,025.60
United
Setting
Professional
Modifier
None
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69

Where Montana 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.

Montana· 3rd of 51

$5,248

AK $6,761KY $4,074

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.