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South Dakota rates for HCPCS A9542

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

Facilitymedian $2,692 · 10th–90th $2,692–$4,8980%50%90th$2,692Professionalmedian $3,162 · 10th–90th $2,692–$4,1690%20%10th90th$3,162$20.0$100.0$500.0$2.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,884.03 / $3,467.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $6,025.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,897.79 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,168.69 / $4,570.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,025.60 / $6,025.60 / $6,025.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $5,011.87
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33