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New Mexico rates for HCPCS Q5112

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.51 / $42.66 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $26.92 / $54.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $50.12 / $51.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $33.11 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $30.20 / $56.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $28.18 / $107.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $29.51 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $28.84