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Wisconsin rates for HCPCS A9543

Yttrium Y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,565.42 / $64,565.42 / $64,565.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64,565.42 / $66,069.34 / $69,183.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104,712.85 / $123,026.88 / $125,892.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56,234.13 / $67,608.30 / $169,824.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53,703.18 / $69,183.10 / $141,253.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53,703.18 / $69,183.10 / $117,489.76
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,565.42 / $169,824.37 / $234,422.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,863.01 / $66,069.34 / $83,176.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67,608.30 / $67,608.30 / $281,838.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $58.88 / $19,054.61
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $173,780.08 / $257,039.58
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69,183.10 / $69,183.10 / $281,838.29
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69,183.10 / $83,176.38 / $363,078.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,234.13 / $56,234.13 / $56,234.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67,608.30 / $67,608.30 / $85,113.80