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Indium In-111 Pentetreotide, Diagnostic

Utah 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?

$3,890

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $3,890 for this service. The price depends on where it is billed: about $3,890 from a physician practice, and about $3,890 from a hospital or other facility.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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$3,890$3,890 to $3,981
FacilityA hospital or hospital-owned outpatient department$3,890$3,890 to $4,467

How much rates vary

Facilitymedian $3,890 · 10th to 90th $3,236 to $5,012Professionalmedian $3,890 · 10th to 90th $3,890 to $5,495
$50$100$200$500$1K$2K$5Kfacility $3,890professional $3,890

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
$3,890.45
Median
$3,890.45
Typical High
$3,890.45
Aetna
Setting
Professional
Modifier
None
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$3,890.45
Cigna
Setting
Professional
Modifier
None
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$3,981.07
Molina
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$6,760.83
Typical High
$7,413.10
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$3,090.30
Median
$3,981.07
Typical High
$5,495.41
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$4,365.16
Median
$4,365.16
Typical High
$5,888.44
Select Health
Setting
Facility
Modifier
None
Typical Low
$4,365.16
Median
$4,365.16
Typical High
$4,365.16
United
Setting
Professional
Modifier
None
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$3,890.45

Where Utah 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.

Utah· 42nd of 51

$3,890

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.