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Wisconsin rates for HCPCS A9542

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

Facilitymedian $2,291 · 10th–90th $794–$5,4950%20%10th90th$2,291Professionalmedian $3,631 · 10th–90th $2,291–$11,2200%20%10th90th$3,631$20.0$100.0$500.0$2.0K$10.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,951.21 / $3,630.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $6,456.54 / $14,125.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $912.01 / $5,754.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $6,918.31 / $7,762.47
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,630.78 / $4,570.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $3,548.13 / $4,570.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $8,912.51
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $64.57 / $2,238.72
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,165.95 / $6,165.95
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $9,772.37 / $13,489.63
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $23,988.33
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $6,025.60 / $23,988.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,862.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $5,495.41