go back

Delaware rates for HCPCS A9542

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,521.23 / $2,521.23 / $2,744.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,384.12 / $3,384.12 / $3,384.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,360.00 / $4,200.00 / $6,300.00