go back

Indium In-111 Pentetreotide, Diagnostic

Wisconsin 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?

$5,888

Typical negotiated rate. In Wisconsin, October 2026.

Insurers have agreed to pay about $5,888 for this service. The price depends on where it is billed: about $5,495 from a physician practice, and about $6,166 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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$5,495$3,890 to $12,023
FacilityA hospital or hospital-owned outpatient department$6,166$4,266 to $10,715

How much rates vary

Facilitymedian $6,166 · 10th to 90th $3,715 to $12,023Professionalmedian $5,495 · 10th to 90th $3,890 to $18,197
$500$1K$2K$5K$10K$20Kfacility $6,166professional $5,495

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
None
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$9,772.37
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$3,715.35
Median
$3,981.07
Typical High
$4,466.84
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$3,890.45
Median
$7,079.46
Typical High
$24,547.09
Cigna
Setting
Facility
Modifier
None
Typical Low
$5,754.40
Median
$9,549.93
Typical High
$12,022.64
Cigna
Setting
Professional
Modifier
None
Typical Low
$3,981.07
Median
$5,888.44
Typical High
$12,589.25
DeanCare
Setting
Facility
Modifier
None
Typical Low
$3,715.35
Median
$5,888.44
Typical High
$14,791.08
DeanCare
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$204.17
Typical High
$6,606.93
Medica
Setting
Facility
Modifier
None
Typical Low
$1,905.46
Median
$4,677.35
Typical High
$13,182.57
Medica
Setting
Professional
Modifier
None
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$6,165.95
Network Health
Setting
Facility
Modifier
None
Typical Low
$6,606.93
Median
$6,606.93
Typical High
$6,606.93
Network Health
Setting
Professional
Modifier
None
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
Prevea360
Setting
Facility
Modifier
None
Typical Low
$3,715.35
Median
$5,888.44
Typical High
$14,791.08
Quartz
Setting
Professional
Modifier
None
Typical Low
$6,606.93
Median
$12,882.50
Typical High
$19,498.45
Quartz
Setting
Facility
Modifier
None
Typical Low
$5,248.07
Median
$12,022.64
Typical High
$12,022.64
Quartz
Setting
Professional
Modifier
None
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$9,120.11
United
Setting
Facility
Modifier
None
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
United
Setting
Professional
Modifier
None
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$5,248.07

Where Wisconsin 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.

Wisconsin· 4th of 51

$5,888

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.