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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 July 2026.

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

$6,310

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $6,310 for this service. The price depends on where it is billed: about $4,169 from a physician practice, and about $7,079 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$4,169$4,169 to $7,079
FacilityA hospital or hospital-owned outpatient department$7,079$6,457 to $7,244

How much rates vary

Facilitymedian $7,079 · 10th to 90th $6,310 to $9,772Professionalmedian $4,169 · 10th to 90th $4,169 to $7,244
$100.0$500.0$2.0K$10.0Kfacility $7,079professional $4,169

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4,073.80
Median
$4,168.69
Typical High
$4,168.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6,456.54
Median
$9,772.37
Typical High
$24,547.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$4,265.80
Typical High
$6,606.93
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$6,309.57
Median
$7,079.46
Typical High
$7,244.36
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$6,309.57
Median
$7,079.46
Typical High
$7,244.36
Providence
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$6,606.93
Typical High
$24,547.09
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$3,890.45
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69

Where Montana sits

The same service costs 4.2 times more in Alaska than in Minnesota. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Montana $6,310 · 2nd of 51
AK $6,761MN $1,622

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.