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Pennsylvania 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
$61.52 / $116.29 / $152.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.90 / $61.52 / $61.52
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.87 / $119.33 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.33 / $119.33 / $119.33
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
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.31 / $60.31 / $126.65
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.52 / $92.28 / $158.72
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.90 / $61.52 / $103.97
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.20 / $117.90 / $130.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.52 / $61.52 / $61.52
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.52 / $61.52 / $61.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $60.32 / $75.40