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New Jersey rates for HCPCS A9572

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

Facilitymedian $6,310 · 10th–90th $3,162–$13,4900%10%10th90th$6,310Professionalmedian $3,981 · 10th–90th $3,715–$4,6770%20%40%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
$3,981.07 / $6,309.57 / $13,182.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,981.07 / $4,677.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $4,677.35 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $6,918.31 / $14,791.08
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,344.23 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $5,754.40