go back

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.

Facilitymedian $7,079 · 10th–90th $126$9,7720%50%10th90th$7,079Professionalmedian $3,802 · 10th–90th $126$7,0790%20%10th90th$3,802$100.0$500.0$2.0K$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
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