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
Tennessee
Hospital Address Code Price Last Updated
Riverview Regional Medical Center 158 Hospital Drive, Carthage A9572 $1,781 [source] 4 years ago
Southern Tennessee Regional Health System - Pulaski 1265 East College Street, Pulaski A9572 $1,930 [source] 4 years ago
St. Jude Children's Research Hospital , Memphis A9572 $3,394 [source] 4 years ago
Southern Tennessee Regional Health System - Winchester 185 Hospital Road, Winchester A9572 $4,028 [source] 4 years ago
Southern Tennessee Regional Health System - Lawrenceburg 1607 South Locust Avenue, Lawrenceburg A9572 $4,578 [source] 4 years ago
Sumner Regional Medical Center 555 Hartsville Pike, Gallatin A9572 $4,900 [source] 4 years ago
Trousdale Medical Center 500 Church Street, Hartsville A9572 $9,478 [source] 4 years ago
Saint Thomas River Park Hospital, Llc 120 Walnut Commons Ln Ste D, Cookeville A9572 $13,917 [source] 4 years ago
Ascension Saint Thomas Stones River 324 Doolittle Rd, Woodbury A9572 $13,917 [source] 4 years ago
Ascension Saint Thomas Dekalb 520 W Main St, Smithville A9572 $13,917 [source] 4 years ago
Saint Thomas Hickman Hospital 1518 Highway 100, Centerville A9572 $13,917 [source] 4 years ago
Ascension Saint Thomas Highlands 401 Sewell Dr, Sparta A9572 $13,917 [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.