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Indium In-111 Satumomab Pendetide, Diagnostic

Montana 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?

$2,089

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $2,089 for this service. The price depends on where it is billed: about $1,660 from a physician practice, and about $2,884 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,660$1,660 to $2,291
FacilityA hospital or hospital-owned outpatient department$2,884$2,089 to $2,951

How much rates vary

Facilitymedian $2,884 · 10th to 90th $1,660 to $3,311Professionalmedian $1,660 · 10th to 90th $79 to $2,630
$100$200$500$1K$2K$5K$10Kfacility $2,884professional $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
$1,380.38
Median
$1,380.38
Typical High
$1,380.38
Cigna
Setting
Facility
Modifier
None
Typical Low
$2,630.27
Median
$2,630.27
Typical High
$10,000.00
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$2,630.27
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$1,659.59
Median
$2,884.03
Typical High
$3,090.30
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$1,659.59
Median
$1,862.09
Typical High
$3,090.30
Providence
Setting
Facility
Modifier
None
Typical Low
$2,630.27
Median
$2,630.27
Typical High
$10,000.00
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$2,187.76
Typical High
$2,570.40
United
Setting
Professional
Modifier
None
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59

Where Montana 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.

Montana· 3rd of 51

$2,089

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.