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North Dakota rates for HCPCS A9572

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

Facilitymedian $3,715 · 10th–90th $3,715–$4,7860%50%90th$3,715Professionalmedian $3,981 · 10th–90th $3,236–$4,6770%20%40%10th90th$3,981$2.0K$5.0K$10.0K$20.0K

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
$3,715.35 / $3,715.35 / $4,677.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,981.07 / $4,677.35
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $4,073.80 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,981.07 / $5,011.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,786.30 / $6,606.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $38,904.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $8,511.38