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Maryland rates for HCPCS Q5112

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $8,912.51 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $26.92 / $48.98
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $26.30 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $27.54 / $95.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $27.54 / $32.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $30.20 / $33.11
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $26.30 / $35.48