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Iowa rates for HCPCS A9572

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

Facilitymedian $4,677 · 10th–90th $3,162–$4,6770%50%10th$4,677Professionalmedian $3,981 · 10th–90th $3,715–$4,6770%20%40%10th90th$3,981$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
$3,715.35 / $4,677.35 / $4,677.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,981.07 / $4,677.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $4,897.79 / $7,413.10
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $5,754.40 / $6,760.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $4,677.35 / $15,488.17
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $15,135.61
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,413.10 / $9,772.37 / $15,488.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $10,715.19 / $10,715.19
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,079.46 / $7,943.28 / $9,332.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $4,786.30
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,168.69 / $4,168.69