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Tennessee rates for HCPCS A9572

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

Facilitymedian $4,467 · 10th–90th $1,995–$38,9050%10%10th90th$4,467Professionalmedian $3,890 · 10th–90th $3,890–$4,6770%50%90th$3,890$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,890.45 / $4,677.35
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $6,025.60 / $6,918.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38,904.51 / $38,904.51 / $38,904.51
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38,904.51 / $38,904.51 / $38,904.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,041.74 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $3,981.07