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Indiana rates for HCPCS Q0180

Dolasetron mesylate, 100 mg, oral, FDA-approved prescription antiemetic, for use as a complete therapeutic substitute for an IV antiemetic at the time of chemotherapy treatment, not to exceed a 24-hour dosage regimen

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.90 / $144.77 / $260.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.90 / $57.90 / $61.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.37 / $120.64 / $195.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.98 / $101.24 / $136.38
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.00 / $61.20 / $106.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.00 / $56.10 / $76.72
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 / $88.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $60.32 / $66.34