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Indium In-111 Satumomab Pendetide, Diagnostic

Tennessee rates for HCPCS A4642

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

Rates data updated July 2026.

Facilitymedian $2,188 · 10th–90th $1,380$10,2330%10%10th90th$2,188Professionalmedian $1,380 · 10th–90th $1,380$1,4450%50%90th$1,380$1.0K$2.0K$5.0K$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
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$1,445.44
Typical High
$2,454.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,380.38
Typical High
$1,412.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$2,089.30
Typical High
$2,511.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$10,232.93
Median
$10,232.93
Typical High
$10,232.93
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$10,232.93
Median
$14,125.38
Typical High
$14,125.38
United
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$3,630.78
Typical High
$3,630.78
United
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,659.59
Typical High
$1,659.59