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Oklahoma 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
$58.63 / $58.63 / $116.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.90 / $59.35 / $61.52
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.63 / $66.84 / $118.45
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $60.32 / $477.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.97 / $60.32 / $66.83