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California rates for HCPCS A4642

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

Facilitymedian $6,607 · 10th–90th $1,380–$11,4820%10%10th90th$6,607Professionalmedian $1,380 · 10th–90th $1,122–$1,7780%20%40%10th90th$1,380$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $6,918.31 / $13,489.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,380.38 / $1,659.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $229.09 / $1,621.81
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $562.34 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,818.38 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,232.93 / $10,232.93 / $10,232.93
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,232.93 / $14,125.38 / $14,125.38
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,187.76 / $3,467.37
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,495.41 / $5,495.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $3,548.13