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South Dakota rates for HCPCS A9572

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

Facilitymedian $4,677 · 10th–90th $4,677–$7,0790%50%90th$4,677Professionalmedian $3,981 · 10th–90th $3,890–$4,8980%20%10th90th$3,981$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 / $4,677.35 / $4,677.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,981.07 / $4,677.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $4,897.79
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $7,079.46 / $11,481.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,890.45 / $4,365.16
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,772.37 / $9,772.37 / $9,772.37
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $8,128.31
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69