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North Dakota rates for HCPCS A9542

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

Facilitymedian $3,467 · 10th–90th $2,692–$3,5480%20%40%10th90th$3,467Professionalmedian $3,162 · 10th–90th $2,512–$3,7150%20%10th90th$3,162$2.0K$5.0K$10.0K$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
$2,691.53 / $2,754.23 / $3,467.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,884.03 / $3,548.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,715.35 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $6,025.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $4,570.88 / $6,025.60
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $23,988.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $5,495.41