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Indium In-111 Ibritumomab Tiuxetan, Diagnostic

Pennsylvania rates for HCPCS A9542

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

Rates data updated October 2026.

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

$3,548

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $3,548 for this service. The price depends on where it is billed: about $3,548 from a physician practice, and about $4,898 from a hospital or other facility.

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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3,548$2,512 to $4,169
FacilityA hospital or hospital-owned outpatient department$4,898$3,311 to $12,882

How much rates vary

Facilitymedian $4,898 · 10th to 90th $2,570 to $14,454Professionalmedian $3,548 · 10th to 90th $2,344 to $4,365
$5K$10K$20K$50Kfacility $4,898professional $3,548

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$2,344.23
Median
$2,344.23
Typical High
$2,511.89
Aetna
Setting
Professional
Modifier
None
Typical Low
$2,344.23
Median
$2,511.89
Typical High
$2,754.23
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$2,454.71
Median
$2,754.23
Typical High
$5,011.87
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$2,754.23
Cigna
Setting
Facility
Modifier
None
Typical Low
$3,548.13
Median
$5,888.44
Typical High
$13,489.63
Cigna
Setting
Professional
Modifier
None
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$3,548.13
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$2,511.89
Median
$2,951.21
Typical High
$2,951.21
Geisinger
Setting
Professional
Modifier
None
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$2,344.23
Median
$2,344.23
Typical High
$2,344.23
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$2,344.23
Median
$2,511.89
Typical High
$2,511.89
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$3,981.07
Median
$11,481.54
Typical High
$18,620.87
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$3,981.07
Median
$4,365.16
Typical High
$4,365.16
United
Setting
Professional
Modifier
None
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$5,754.40

Where Pennsylvania sits

The same service costs 1.9 times more in Alaska than in Indiana. 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.

Pennsylvania· 27th of 51

$3,548

AK $6,026IN $3,236

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.