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Maryland 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
$61.52 / $61.52 / $61.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.90 / $61.52 / $61.52
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.76 / $56.76 / $73.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.52 / $61.52 / $61.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.20 / $72.52 / $105.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $60.32 / $62.13
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.76 / $94.76 / $94.76