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Virginia 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 / $67.18 / $132.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.90 / $61.52 / $61.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.90 / $57.90 / $96.46
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.76 / $56.76 / $56.76
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.43 / $68.04 / $113.03
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.52 / $63.84 / $103.97
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.00 / $101.00 / $235.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $60.32 / $63.34