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Mississippi rates for HCPCS A9542

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $3,090.30 / $3,162.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,818.38 / $3,162.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,071.52 / $1,071.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $3,548.13 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,548.13 / $3,548.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $50.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $851.14 / $851.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $4,168.69 / $5,495.41