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Colorado rates for HCPCS A9542

Indium In-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,802.50 / $1,802.50 / $1,802.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,802.50 / $1,802.50 / $3,040.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $843.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,570.00 / $4,146.68 / $4,146.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,384.12 / $3,384.12 / $3,384.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,384.12 / $3,384.12 / $3,384.12
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,802.50 / $2,577.58 / $4,200.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,200.00 / $4,200.00 / $4,200.00