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New Jersey rates for HCPCS Q5112

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $40.74 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $26.92 / $48.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $21.38 / $27.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $28.18 / $48.98
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $9,549.93 / $25,118.86
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $23.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $46.77 / $120.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $28.84 / $32.36