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North Carolina rates for HCPCS A9572

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

Facilitymedian $5,754 · 10th–90th $3,467–$6,7610%50%10th90th$5,754Professionalmedian $3,981 · 10th–90th $3,715–$5,7540%20%10th90th$3,981$100.0$500.0$2.0K$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
$5,754.40 / $5,754.40 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,981.07 / $5,754.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $5,754.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $5,888.44 / $9,332.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $5,754.40 / $7,244.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,162.28 / $3,548.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $5,128.61
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38,904.51 / $38,904.51 / $38,904.51
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38,904.51 / $38,904.51 / $38,904.51