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Pennsylvania rates for HCPCS A9571

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

Facilitymedian $5,495 · 10th–90th $4,266–$26,3030%20%10th90th$5,495Professionalmedian $4,266 · 10th–90th $4,074–$4,2660%50%10th$4,266$1.0$5.0$20.0$100.0$500.0$2.0K$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 / $5,495.41 / $26,302.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,265.80 / $4,265.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $15,135.61 / $16,218.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $4,073.80
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,265.80 / $4,265.80
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $4,466.84
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $5,011.87