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North Carolina rates for HCPCS Q5112

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.85 / $90.07 / $128.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.95 / $90.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.16 / $33.54 / $50.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.19 / $18.19 / $33.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.34 / $19.00 / $52.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $61.24
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.00 / $58.34 / $114.62
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $38.00 / $58.34
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.40 / $31.25 / $113.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $20.14 / $23.75
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.97 / $116.05 / $461.50
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.69 / $121.69 / $145.08