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Texas rates for HCPCS A9571

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

Facilitymedian $11,220 · 10th–90th $4,169$15,1360%20%40%10th90th$11,220Professionalmedian $4,169 · 10th–90th $4,074$4,7860%50%10th90th$4,169$50.0$200.0$1.0K$5.0K$20.0K

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 / $15,135.61 / $15,135.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,168.69 / $4,786.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $10,000.00 / $28,840.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15,135.61 / $15,135.61 / $15,135.61
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22,908.68 / $22,908.68 / $22,908.68
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $5,011.87 / $15,135.61
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,168.69 / $4,677.35
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $5,011.87 / $13,489.63
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $7,585.78 / $7,585.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $4,786.30