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Missouri rates for HCPCS A9542

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

Facilitymedian $4,169 · 10th–90th $0–$8,3180%20%10th90th$4,169Professionalmedian $3,162 · 10th–90th $2,089–$4,1690%20%10th90th$3,162$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$1,698.24 / $3,981.07 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,884.03 / $3,981.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $8,317.64 / $8,317.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $4,168.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $8,317.64 / $8,912.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $4,168.69 / $21,877.62
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,168.69 / $6,606.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $977.24 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,168.69 / $4,265.80