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Indiana rates for HCPCS A9572

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

Facilitymedian $5,754 · 10th–90th $2,884–$8,9130%20%10th90th$5,754Professionalmedian $3,715 · 10th–90th $871–$4,6770%50%10th90th$3,715$1.0K$2.0K$5.0K$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 / $3,715.35 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $4,677.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $5,754.40 / $8,511.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $831.76 / $6,760.83
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,495.41 / $9,772.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $10,964.78 / $10,964.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $4,677.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,801.89 / $3,801.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $6,606.93