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New Jersey rates for HCPCS A4642

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

Facilitymedian $2,291 · 10th–90th $1,413–$4,7860%20%10th90th$2,291Professionalmedian $1,413 · 10th–90th $1,349–$1,6600%50%10th90th$1,413$5.0$20.0$100.0$500.0$2.0K$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
$1,412.54 / $2,290.87 / $4,786.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,412.54 / $1,659.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,445.44 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,623.41 / $6,309.57 / $6,309.57
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $1,659.59 / $2,187.76