go back

Tennessee rates for HCPCS Q5112

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $28.59 / $8,814.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.19 / $37.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.99 / $21.99 / $21.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.58 / $24.43 / $31.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $19.00 / $26.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $19.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.97 / $461.50 / $461.50
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.69 / $126.91 / $145.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.05 / $19.00 / $22.42