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Florida rates for HCPCS A9542

Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,360.00 / $3,486.00 / $4,818.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,521.23 / $3,403.99 / $3,486.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$837.92 / $3,384.12 / $3,384.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,384.12 / $3,384.12 / $3,384.12
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,769.63 / $2,880.42 / $2,880.42
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,581.11 / $2,769.63 / $3,162.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $50.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,200.00 / $4,200.00 / $4,326.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,403.03 / $4,403.03 / $4,403.03