go back

Massachusetts rates for HCPCS A4642

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

Facilitymedian $2,692 · 10th–90th $1,413–$5,1290%20%10th90th$2,692Professionalmedian $1,660 · 10th–90th $1,349–$2,9510%20%10th90th$1,660$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
$1,412.54 / $1,412.54 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,412.54 / $1,698.24
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,232.93 / $10,232.93 / $10,232.93
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,659.59 / $10,232.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $5,370.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,019.95 / $6,165.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $5,888.44 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $3,235.94
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,232.93 / $10,232.93 / $10,232.93
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,659.59 / $10,232.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,691.53 / $3,467.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,659.59 / $2,754.23