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Michigan rates for HCPCS J9355

Injection, trastuzumab, excludes biosimilar, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.28 / $102.01 / $5,785.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.03 / $76.53 / $92.18
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.03 / $75.03 / $75.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.16 / $163.63 / $311.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.27 / $78.02 / $101.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.03 / $82.53 / $114.27
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.03 / $78.78 / $173.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.02 / $75.02 / $97.96
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.03 / $124.67 / $218.34
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.03 / $77.28 / $97.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.03 / $82.53 / $112.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.69 / $75.69 / $80.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.03 / $83.52 / $96.05