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Georgia rates for HCPCS A9542

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

Facilitymedian $1,549 · 10th–90th $0–$2,9510%20%10th90th$1,549Professionalmedian $3,548 · 10th–90th $2,512–$4,1690%20%40%10th90th$3,548$0.0$0.2$2.0$20.0$200.0$2.0K

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
$2,818.38 / $2,951.21 / $3,311.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,951.21 / $3,801.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,801.89 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,890.45 / $6,309.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,897.79 / $12,589.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,548.82 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,570.88