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Nebraska rates for HCPCS A9572

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

Facilitymedian $1,995 · 10th–90th $427–$7,4130%20%10th90th$1,995Professionalmedian $3,715 · 10th–90th $3,715–$6,0260%50%90th$3,715$500.0$1.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $7,413.10 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $3,981.07
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $501.19 / $977.24
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,754.40 / $5,888.44 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $4,897.79 / $14,791.08
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,715.35 / $35,481.34
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $9,772.37
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $15,848.93
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,791.08 / $14,791.08 / $15,848.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,995.26 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,890.45 / $4,677.35