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Arizona rates for HCPCS Q5112

Injection, trastuzumab-dttb, biosimilar, (Ontruzant), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.32 / $39.40 / $92.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.19 / $26.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.59 / $82.97 / $381.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.23 / $63.58 / $92.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $19.00 / $29.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $19.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.99 / $26.60 / $51.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.99 / $21.99 / $47.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $21.15