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Minnesota rates for HCPCS A9542

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

Facilitymedian $2,399 · 10th–90th $977–$14,4540%10%10th90th$2,399Professionalmedian $3,467 · 10th–90th $2,692–$3,5480%50%10th90th$3,467$1.0$10.0$100.0$1.0K$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,754.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,754.23 / $3,630.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,951.21 / $19,498.45
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,467.37 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,122.02 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $6,025.60
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $6,309.57 / $6,309.57
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $4,168.69 / $7,413.10
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $8,912.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $7,585.78