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Mississippi rates for HCPCS A9572

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,808.08 / $3,808.08 / $5,572.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,808.08 / $5,572.80 / $6,269.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,130.08 / $6,130.08 / $6,130.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,297.53 / $3,947.40 / $3,947.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,947.40 / $3,947.40 / $3,947.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,723.14 / $1,914.61 / $5,998.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.20 / $3,870.00 / $5,031.00