go back

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 July 2026.

Facilitymedian $6,026 · 10th–90th $2,344$15,8490%10%20%10th90th$6,026Professionalmedian $2,951 · 10th–90th $2,344$3,8020%20%10th90th$2,951$2.0K$5.0K$10.0K$20.0K$50.0K

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
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$3,235.94
Typical High
$14,454.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,344.23
Median
$2,511.89
Typical High
$3,548.13
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$2,754.23
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$2,754.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$12,302.69
Typical High
$13,182.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$3,548.13
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$2,951.21
Typical High
$2,951.21
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$3,981.07
Typical High
$14,454.40
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$2,344.23
Median
$2,511.89
Typical High
$6,025.60
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$5,888.44
Median
$12,882.50
Typical High
$21,379.62
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$4,365.16
United
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$4,168.69
Typical High
$5,011.87