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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 July 2026.

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

$8,710

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $8,710 for this service. The price depends on where it is billed: about $3,890 from a physician practice, and about $10,965 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3,890$3,890 to $10,715
FacilityA hospital or hospital-owned outpatient department$10,965$10,471 to $16,596

How much rates vary

Facilitymedian $10,965 · 10th to 90th $195 to $66,069Professionalmedian $3,890 · 10th to 90th $195 to $10,965
$100$1K$10K$100Kfacility $10,965professional $3,890

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,890.45
Typical High
$3,890.45
BCBS
Setting
Facility
Modifier
Global
Typical Low
$14,125.38
Median
$64,565.42
Typical High
$89,125.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$15,848.93
Typical High
$39,810.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$10,000.00
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$10,715.19
Typical High
$10,964.78
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$10,715.19
Typical High
$10,964.78
Providence
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$10,471.29
Typical High
$39,810.72
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$3,981.07
Typical High
$12,882.50
United
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$3,890.45

Where Montana sits

The same service costs 4.9 times more in Montana 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· 1st of 51

$8,710

MT $8,710MN $1,778

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.