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Indium In-111 Satumomab Pendetide, Diagnostic

Ohio rates for HCPCS A4642

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

Rates data updated July 2026.

Facilitymedian $3,162 · 10th–90th $1,349$3,7150%50%10th90th$3,162Professionalmedian $1,349 · 10th–90th $1,000$1,6600%50%10th90th$1,349$0.0$0.2$2.0$20.0$200.0$2.0K$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
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$3,162.28
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$1,584.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.03
Typical High
$1,584.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$3,548.13
Typical High
$4,168.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$3,548.13
Typical High
$4,365.16
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$50.12
Typical High
$60.26
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
United
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$3,630.78
Typical High
$3,630.78
United
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,819.70