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Utah rates for HCPCS A9542

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

Facilitymedian $3,467 · 10th–90th $1,445–$3,4670%50%10th$3,467Professionalmedian $3,467 · 10th–90th $2,512–$4,1690%20%10th90th$3,467$50.0$200.0$1.0K$5.0K

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
$3,467.37 / $3,467.37 / $3,467.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,951.21 / $3,467.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $60.26 / $4,677.35
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,621.81 / $2,290.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $5,248.07
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,981.07 / $4,786.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69