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Maryland rates for HCPCS A9572

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

Facilitymedian $5,623 · 10th–90th $3,981–$5,6230%50%10th$5,623Professionalmedian $3,981 · 10th–90th $3,715–$4,6770%20%40%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,623.41 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,981.07 / $4,677.35
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,365.16 / $7,585.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $4,365.16 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $4,677.35
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95