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Indium In-111 Ibritumomab Tiuxetan, Diagnostic

Wisconsin rates for HCPCS A9542

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

Rates data updated October 2026.

How much does Indium In-111 Ibritumomab Tiuxetan, Diagnostic cost?

$5,495

Typical negotiated rate. In Wisconsin, October 2026.

Insurers have agreed to pay about $5,495 for this service. The price depends on where it is billed: about $5,495 from a physician practice, and about $4,571 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$5,495$4,169 to $9,333
FacilityA hospital or hospital-owned outpatient department$4,571$3,162 to $10,715

How much rates vary

Facilitymedian $4,571 · 10th to 90th $2,754 to $10,715Professionalmedian $5,495 · 10th to 90th $3,311 to $17,378
$100$1K$10Kfacility $4,571professional $5,495

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$2,754.23
Aetna
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$2,754.23
Typical High
$2,754.23
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$3,801.89
Median
$8,912.51
Typical High
$22,387.21
Cigna
Setting
Facility
Modifier
None
Typical Low
$5,495.41
Median
$5,754.40
Typical High
$10,715.19
Cigna
Setting
Professional
Modifier
None
Typical Low
$3,548.13
Median
$5,128.61
Typical High
$7,762.47
DeanCare
Setting
Facility
Modifier
None
Typical Low
$3,162.28
Median
$4,168.69
Typical High
$9,772.37
Medica
Setting
Facility
Modifier
None
Typical Low
$794.33
Median
$4,168.69
Typical High
$8,709.64
Medica
Setting
Professional
Modifier
None
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$6,025.60
Network Health
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$4,265.80
Typical High
$4,265.80
Network Health
Setting
Professional
Modifier
None
Typical Low
$6,165.95
Median
$6,165.95
Typical High
$6,165.95
Prevea360
Setting
Facility
Modifier
None
Typical Low
$3,162.28
Median
$4,168.69
Typical High
$9,772.37
Quartz
Setting
Professional
Modifier
None
Typical Low
$4,466.84
Median
$8,709.64
Typical High
$12,882.50
Quartz
Setting
Facility
Modifier
None
Typical Low
$5,754.40
Median
$10,715.19
Typical High
$10,715.19
Quartz
Setting
Professional
Modifier
None
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$6,165.95
United
Setting
Professional
Modifier
None
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$5,754.40

Where Wisconsin sits

The same service costs 1.9 times more in Alaska than in Indiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 2nd of 51

$5,495

AK $6,026IN $3,236

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.