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South Carolina rates for HCPCS A4642

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

Facilitymedian $2,138 · 10th–90th $1,380–$5,4950%20%10th90th$2,138Professionalmedian $1,413 · 10th–90th $1,349–$1,6600%20%40%10th90th$1,413$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,380.38 / $5,011.87 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,412.54 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,511.89 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,513.56 / $1,778.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,778.28