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Maine 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
Professional
Modifier
Low / Median / High Price
$59.35 / $61.52 / $72.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.50 / $186.50 / $186.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $61.52 / $67.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.52 / $61.52 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.52 / $61.52 / $61.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.24 / $101.24 / $101.24
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.35 / $61.52 / $61.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $60.32 / $97.44