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Arizona rates for HCPCS A9572

Indium In-111 pentetreotide, diagnostic, per study dose, up to 6 mCi

Facilitymedian $7,244 · 10th–90th $1,995–$19,4980%5%10th90th$7,244Professionalmedian $3,890 · 10th–90th $3,715–$5,6230%20%40%10th90th$3,890$2.0K$5.0K$10.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,890.45 / $5,623.41
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $12,022.64 / $21,877.62
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $37,153.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $6,456.54 / $7,413.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $5,370.32 / $9,772.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $38,904.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,995.26 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $4,265.80