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Pennsylvania rates for HCPCS A9542

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

Facilitymedian $3,236 · 10th–90th $2,344–$13,1830%10%10th90th$3,236Professionalmedian $2,884 · 10th–90th $2,344–$3,9810%20%10th90th$2,884$1.0$10.0$100.0$1.0K$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
$2,344.23 / $3,235.94 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,818.38 / $3,548.13
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,754.23 / $5,495.41
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $2,754.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $12,302.69 / $13,182.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $2,951.21
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,344.23
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,818.38 / $3,548.13
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $4,365.16
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $4,365.16
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,168.69 / $5,011.87