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Wyoming rates for HCPCS A9572

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.20 / $3,715.20 / $3,715.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,947.40 / $4,644.00 / $4,644.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,947.40 / $3,947.40 / $3,947.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,870.00 / $3,870.00 / $3,870.00