HCPCS A4642

Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries

Current code8 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS A4642 by hospital
Hospital	Commercial insurance rates (lowest – highest)	Cash price	List price (before discounts)
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01	$4,870 – $6,1692 plans	—	—
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01	$2,567 – $2,7333 plans	—	—
PeaceHealth Peace Island Medical CenterFriday Harbor	—	$12,925	$19,884
PeaceHealth Southwest Medical CenteVancouver	—	$12,925	$19,884
PeaceHealth St John Medical CenterLongview	—	$12,925	$19,884
PeaceHealth St Joseph Medical CenterBellingham	—	$12,925	$19,884
PeaceHealth United General Medical CenterSedro Woolley	—	$12,925	$19,884
Providence Centralia HospitalCentraliaFile dated 2026-04-01	$4,870 – $6,1692 plans	—	—

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.