Code: A9572

Description:
Description: Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Other Descriptions:
HC INDIUM IN-111 PENTETREOTIDE DX DOSE TO 6 MCI
HC RP 111 IN PENETETRTD TO 6MC
INDIUM IN-111 PENTETREOTIDE DX DOSE TO 6 MCI
INDIUM IN111 PENTETREOTIDE DIAGNOSTIC PER MILLICURIE
IND111 PENTREOTIDE DOSE 6MCI
IN-111 PENTETREOTIDE/DOSE
RX DX 111In Octreo per Dose
Ind111 Pentetreotide Dose
Related codes:
Code: A9570
IN111 AUTO WBC DX DOSE
Code: A9571
Description: Indium in-111 labeled autologous platelets, diagnostic, per study dose
HCPCS Category: Transportation, medical and surgical supplies, miscellaneous and experimental
Code: A9575
GADOTERATE MEG 10 ML
Code: A9576
PROHANCE MULTIPK 1 ML
Code: A9577
MULTIHANCE 5 ML
Code: A9578
MULTIHANCE MULTIPAC 1 ML
Code: A9579
GAD BASE MR CONT NOS 1ML
Nebraska
Hospital Address Code Price Last Updated
Chi Health St. Francis 2116 W Faidley Ave, Grand Island A9572 $2,733 [source] 4 years ago
Chi Health St. Elizabeth 555 S. 70Th St., Lincoln A9572 $4,385 [source] 4 years ago
Chi Health Good Samaritan 10 E 31St St, Kearney A9572 $6,889 [source] 4 years ago
Chi Health Schuyler 1721 Colfax St, Schuyler A9572 $9,620 [source] 4 years ago
Chi Health Plainview 704 N 3Rd St, Plainview A9572 $9,620 [source] 4 years ago
Chi Health Lakeside 17201 Wright St, Omaha A9572 $11,314 [source] 4 years ago
Chi Health Midlands 11111 S 84Th St, Papillion A9572 $11,314 [source] 4 years ago
Chi Health Creighton University Medical Center - Bergan Mercy 7500 Mercy Rd, Omaha A9572 $11,314 [source] 4 years ago
Chi Health Immanuel 7101 Newport Ave, Omaha A9572 $11,314 [source] 4 years ago
ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.