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Indium In-111 Ibritumomab Tiuxetan, Diagnostic

Montana rates for HCPCS A9542

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

Rates data updated October 2026.

How much does Indium In-111 Ibritumomab Tiuxetan, Diagnostic cost?

$5,129

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $5,129 for this service. The price depends on where it is billed: about $4,169 from a physician practice, and about $7,079 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$4,169$3,890 to $5,370
FacilityA hospital or hospital-owned outpatient department$7,079$5,129 to $7,244

How much rates vary

Facilitymedian $7,079 · 10th to 90th $4,074 to $11,482Professionalmedian $4,169 · 10th to 90th $79 to $6,457
$100$500$2K$10Kfacility $7,079professional $4,169

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$3,801.89
Cigna
Setting
Facility
Modifier
None
Typical Low
$6,456.54
Median
$6,456.54
Typical High
$24,547.09
Cigna
Setting
Professional
Modifier
None
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$6,456.54
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$4,073.80
Median
$7,079.46
Typical High
$7,585.78
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$4,073.80
Median
$4,570.88
Typical High
$7,585.78
Providence
Setting
Facility
Modifier
None
Typical Low
$6,456.54
Median
$6,456.54
Typical High
$24,547.09
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$5,128.61
Typical High
$6,025.60
United
Setting
Professional
Modifier
None
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69

Where Montana sits

The same service costs 1.9 times more in Alaska than in Indiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 3rd of 51

$5,129

AK $6,026IN $3,236

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.