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Indium In-111 Pentetreotide, Diagnostic

Maryland rates for HCPCS A9572

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

Rates data updated July 2026.

Facilitymedian $4,365 · 10th–90th $3,981$5,6230%20%40%10th90th$4,365Professionalmedian $3,981 · 10th–90th $3,890$5,7540%50%10th90th$3,981$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$7,943.28
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$4,365.16
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$3,981.07
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$4,365.16
Typical High
$6,606.93
United
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$4,365.16
Typical High
$4,677.35
United
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$4,786.30
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$3,019.95