go back

Arkansas rates for HCPCS Q5112

Injection Trastuzumab-Dttb Biosimilar (Ontruzant) 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.80 / $25.29 / $27.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.95 / $24.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.88 / $43.88 / $43.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $43.88 / $43.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.34 / $19.00 / $26.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.01 / $19.00 / $19.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $20.14 / $24.32