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Indium In-111 Satumomab Pendetide, Diagnostic

Arizona rates for HCPCS A4642

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

Rates data updated October 2026.

How much does Indium In-111 Satumomab Pendetide, Diagnostic cost?

$1,660

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $1,660 for this service. Most negotiated rates run $1,445 to $1,995.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2,239 · 10th to 90th $1,479 to $2,692Professionalmedian $1,660 · 10th to 90th $1,349 to $10,233
$2K$5K$10Kfacility $2,239professional $1,660

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
Professional
Modifier
None
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$1,348.96
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,778.28
Median
$2,511.89
Typical High
$2,630.27
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44
Medica
Setting
Facility
Modifier
None
Typical Low
$1,348.96
Median
$1,479.11
Typical High
$3,235.94
Medica
Setting
Professional
Modifier
None
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$10,232.93
United
Setting
Professional
Modifier
None
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$134.90
Median
$134.90
Typical High
$134.90

Where Arizona sits

The same service costs 33.1 times more in Alaska than in New York. 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.

Arizona· 8th of 51

$1,660

AK $2,239NY $67.61

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.