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Louisiana 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
$72.44 / $72.44 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $60.26 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $151.36 / $173.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $60.26 / $64.57