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Indium In-111 Pentetreotide, Diagnostic

South Carolina rates for HCPCS A9572

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

Rates data updated October 2026.

How much does Indium In-111 Pentetreotide, Diagnostic cost?

$4,074

Typical negotiated rate. In South Carolina, October 2026.

Insurers have agreed to pay about $4,074 for this service. The price depends on where it is billed: about $4,074 from a physician practice, and about $5,129 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$4,074$3,890 to $4,677
FacilityA hospital or hospital-owned outpatient department$5,129$4,467 to $7,586

How much rates vary

Facilitymedian $5,129 · 10th to 90th $3,802 to $9,772Professionalmedian $4,074 · 10th to 90th $3,802 to $5,248
$50$200$1K$5Kfacility $5,129professional $4,074

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$3,801.89
Aetna
Setting
Professional
Modifier
None
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$5,754.40
BCBS South Carolina
Setting
Professional
Modifier
None
Typical Low
$4,073.80
Median
$4,677.35
Typical High
$5,011.87
Cigna
Setting
Facility
Modifier
None
Typical Low
$4,466.84
Median
$7,585.78
Typical High
$9,772.37
Cigna
Setting
Professional
Modifier
None
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$3,981.07
Medcost
Setting
Facility
Modifier
None
Typical Low
$3,801.89
Median
$4,570.88
Typical High
$5,128.61
Medcost
Setting
Professional
Modifier
None
Typical Low
$4,677.35
Median
$6,456.54
Typical High
$6,456.54
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
United
Setting
Facility
Modifier
None
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$4,265.80
United
Setting
Professional
Modifier
None
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$4,265.80

Where South Carolina sits

The same service costs 2.4 times more in Alaska than in Minnesota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Carolina· 17th of 51

$4,074

AK $9,333MN $3,890

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.