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New Hampshire rates for HCPCS A9571

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

Facilitymedian $6,026 · 10th–90th $4,266–$15,4880%10%20%10th90th$6,026Professionalmedian $4,266 · 10th–90th $4,074–$7,0790%50%10th90th$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $5,128.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,265.80 / $4,265.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $8,709.64 / $15,488.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,265.80 / $4,897.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $9,120.11 / $11,748.98
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 / $8,128.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,265.80