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Indiana rates for HCPCS Q5112

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.19 / $82.01 / $152.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.19 / $22.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $38.00 / $45.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $21.98 / $31.16
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $19.00 / $28.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $23.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $19.00 / $34.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $58.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $20.14 / $25.38