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Nevada rates for HCPCS A9542

Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,759.04 / $3,835.75 / $3,990.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,328.82 / $3,759.04 / $3,835.75
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $798.02 / $798.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,570.00 / $3,570.00 / $3,835.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$798.02 / $3,384.12 / $3,384.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,384.12 / $3,384.12 / $3,384.12
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,200.00 / $4,200.00 / $4,987.50
Hometown Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$881.96 / $881.96 / $881.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,990.00 / $4,200.00 / $4,200.00