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New Hampshire 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
$61.66 / $61.66 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $61.66 / $72.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $125.89 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $61.66 / $70.79
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $102.33 / $107.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $102.33
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $128.82 / $158.49