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New York rates for HCPCS Q0511

Pharmacy supply fee for oral anticancer, oral antiemetic, or immunosuppressive drug(s); for the first prescription in a 30-day period

Facilitymedian $24 · 10th–90th $10–$53,7030%20%40%10th90th$24Professionalmedian $13 · 10th–90th $3–$260%50%10th90th$13$0.1$1.0$20.0$500.0$10.0K$200.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $10.00 / $10.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $2.69 / $3.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $18.20
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $23.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.59 / $44.67
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $25.12 / $35.48
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $30.20 / $35.48