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Kansas rates for HCPCS A4642

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

Facilitymedian $214 · 10th–90th $174–$1,6600%20%10th90th$214Professionalmedian $1,380 · 10th–90th $141–$1,6600%20%40%10th90th$1,380$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$1,348.96 / $1,348.96 / $1,659.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,380.38 / $1,659.59
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $204.17 / $213.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,621.81 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,659.59 / $2,137.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $10,232.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,621.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,862.09