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Indium In-111 Pentetreotide, Diagnostic

Montana rates for HCPCS A9572

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

Rates data updated October 2026.

How much does Indium In-111 Pentetreotide, Diagnostic cost?

$6,761

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $6,761 for this service. The price depends on where it is billed: about $6,026 from a physician practice, and about $9,333 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$6,026$3,890 to $8,710
FacilityA hospital or hospital-owned outpatient department$9,333$6,761 to $10,233

How much rates vary

Facilitymedian $9,333 · 10th to 90th $5,370 to $18,621Professionalmedian $6,026 · 10th to 90th $79 to $9,772
$100$500$2K$10Kfacility $9,333professional $6,026

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$3,890.45
BCBS Montana
Setting
Facility
Modifier
None
Typical Low
$14,125.38
Median
$16,595.87
Typical High
$18,197.01
Cigna
Setting
Facility
Modifier
None
Typical Low
$10,000.00
Median
$10,471.29
Typical High
$39,810.72
Cigna
Setting
Professional
Modifier
None
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$10,000.00
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$5,370.32
Median
$9,120.11
Typical High
$10,000.00
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$5,370.32
Median
$6,025.60
Typical High
$9,772.37
Providence
Setting
Facility
Modifier
None
Typical Low
$10,000.00
Median
$10,471.29
Typical High
$39,810.72
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$8,128.31
Typical High
$9,772.37
United
Setting
Professional
Modifier
None
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$3,890.45

Where Montana sits

The same service costs 2.4 times more in Alaska than in Minnesota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 2nd of 51

$6,761

AK $9,333MN $3,890

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.