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Ohio rates for HCPCS Q5112

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.59 / $61.13 / $4,787.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $26.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.52 / $30.59 / $47.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $21.98 / $32.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $19.00 / $31.35
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $25.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.34 / $19.00 / $37.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $36.49
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.37 / $102.63 / $233.05
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $58.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.90 / $27.39 / $36.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $19.00 / $19.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $23.27