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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
$72.38 / $72.38 / $101.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.63 / $72.38 / $72.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.09 / $63.86 / $79.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.86 / $63.86 / $65.14
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.29 / $60.32 / $67.08