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Indium In-111 Pentetreotide, Diagnostic

New Hampshire rates for HCPCS A9572

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

Rates data updated July 2026.

Facilitymedian $6,026 · 10th–90th $3,090$10,4710%10%10th90th$6,026Professionalmedian $3,981 · 10th–90th $3,981$6,9180%50%90th$3,981$2.0K$5.0K$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
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$4,786.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$4,786.30
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$7,079.46
Typical High
$10,000.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$3,981.07
Typical High
$4,466.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4,466.84
Median
$7,762.47
Typical High
$10,964.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$3,981.07
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$7,585.78
United
Setting
Facility
Modifier
Global
Typical Low
$3,311.31
Median
$3,311.31
Typical High
$3,311.31
United
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$3,981.07
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$5,888.44
Median
$8,317.64
Typical High
$10,964.78