go back

Arizona rates for HCPCS Q0180

Dolasetron Mesylate 100 Mg Oral Fda Approved Prescription Anti-Emetic For Use As A Complete Therapeutic Substitute For An Iv Anti-Emetic At The Time Of Chemotherapy Treatment Not To Exceed A 24 Hour Dosage Regimen (Special Coverage Instructions Apply)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.45 / $144.76 / $217.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.90 / $60.08 / $61.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.11 / $192.16 / $340.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.67 / $57.90 / $65.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.52 / $61.52 / $61.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.52 / $61.52 / $61.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.90 / $73.81 / $114.61
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $60.32 / $477.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $60.32 / $60.32