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South Carolina 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
$59.35 / $59.35 / $239.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.90 / $60.08 / $61.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.09 / $67.09 / $87.98
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.35 / $75.45 / $101.24
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.00 / $77.00 / $77.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.18 / $58.18 / $72.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.27 / $60.32 / $60.92