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Vermont 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
Professional
Modifier
Low / Median / High Price
$61.52 / $61.52 / $61.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.52 / $61.52 / $110.51
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.52 / $61.52 / $110.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.32 / $62.73 / $139.36