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Illinois rates for HCPCS Q5112

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.99 / $33.25 / $77.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $26.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.10 / $215.03 / $1,025.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.35 / $49.35 / $49.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $19.00 / $19.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $34.49
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $98.91 / $254.05
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.70 / $24.70 / $24.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.74 / $40.24 / $43.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $20.14 / $24.19