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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 July 2026.

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

$4,169

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $4,169 for this service. The price depends on where it is billed: about $3,802 from a physician practice, and about $7,079 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3,802$3,802 to $7,079
FacilityA hospital or hospital-owned outpatient department$7,079$6,457 to $7,079

How much rates vary

Facilitymedian $7,079 · 10th to 90th $126 to $9,772Professionalmedian $3,802 · 10th to 90th $126 to $7,079
$100$500$2K$10Kfacility $7,079professional $3,802

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,398.83
Median
$3,801.89
Typical High
$3,801.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6,456.54
Median
$9,772.37
Typical High
$24,547.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$6,456.54
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$7,079.46
Typical High
$7,079.46
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$7,079.46
Typical High
$7,079.46
Providence
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$6,456.54
Typical High
$24,547.09
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$3,548.13
Typical High
$7,943.28
United
Setting
Professional
Modifier
Global
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69

Where Montana sits

The same service costs 3.3 times more in Alaska than in Colorado. 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

$4,169

AK $6,026CO $1,820

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.