go back

Delaware rates for HCPCS A9572

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,947.40 / $3,947.40 / $3,947.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,947.40 / $3,947.40 / $3,947.40
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,914.61 / $1,914.61 / $1,914.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.20 / $3,870.00 / $5,805.00