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Illinois rates for HCPCS A9572

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

Facilitymedian $4,898 · 10th–90th $1,995–$50,1190%20%10th90th$4,898Professionalmedian $3,890 · 10th–90th $3,715–$5,6230%50%10th90th$3,890$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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 / $3,715.35 / $5,623.41
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
$2,570.40 / $25,703.96 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $7,413.10 / $9,549.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $6,165.95 / $7,585.78
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $39.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $4,365.16