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Oregon rates for HCPCS A9542

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

Facilitymedian $3,981 · 10th–90th $3,631–$4,8980%50%10th90th$3,981Professionalmedian $3,162 · 10th–90th $2,291–$3,9810%10%10th90th$3,162$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,981.07 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,019.95 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $6,760.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,511.38 / $9,772.37 / $10,471.29
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,801.89 / $5,623.41
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,467.37 / $4,570.88
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,168.69 / $8,511.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $3,548.13 / $6,918.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,786.30