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
Wisconsin
Hospital Address Code Price Last Updated
River Falls Area Hospital , River Falls A9572 $2,023 [source] 4 years ago
Aspirus Riverview Hospital 410 Dewey St, Wisconsin Rapids A9572 $3,842 [source] 4 years ago
Aspirus Wausau Hospital 333 Pine Ridge Blvd, Wausau A9572 $3,842 [source] 4 years ago
Aspirus Stevens Point Hospital 5409 Vern Holmes Dr, A9572 $3,842 [source] 4 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee A9572 $6,820 [source] 4 years ago
Aurora Sheboygan Memorial Medical Center 2629 N 7Th St, Sheboygan A9572 $6,820 [source] 4 years ago
Aurora Lakeland Medical Center W3930 County Road Nn, Elkhorn A9572 $6,820 [source] 4 years ago
Aurora Medical Center Burlington 252 Mchenry St, Burlington A9572 $6,820 [source] 4 years ago
Aurora Sinai Medical Center 945 N 12Th St, Milwaukee A9572 $6,820 [source] 4 years ago
Aurora Baycare 1160 Kepler Dr, Green Bay A9572 $6,820 [source] 4 years ago
Aurora Medical Center Of Manitowoc County 5000 Memorial Dr, Two Rivers A9572 $6,820 [source] 4 years ago
Aurora Medical Center Summit 36500 Aurora Dr, Oconomowoc A9572 $6,820 [source] 4 years ago
Aurora Medical Center Bay Area 3003 University Dr, Marinette A9572 $6,820 [source] 4 years ago
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy A9572 $6,820 [source] 4 years ago
Aurora West Allis Medical Center 8901 W Lincoln Ave, Milwaukee A9572 $6,820 [source] 4 years ago
Aurora Medical Center Of Washington County 1032 E Sumner St, Hartford A9572 $6,820 [source] 4 years ago
Aurora Medical Center Of Oshkosh 855 N Westhaven Dr, Oshkosh A9572 $6,820 [source] 4 years ago
Aurora Medical Center Grafton 975 Port Washington Road, Grafton A9572 $6,820 [source] 4 years ago
Aurora Medical Center Kenosha 10400 75Th St, Kenosha A9572 $6,820 [source] 4 years ago
Ascension Calumet Hospital 614 Memorial Dr, Chilton A9572 $9,536 [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.