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Vermont rates for HCPCS Q5112

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $320.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.34 / $27.63 / $46.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $46.05
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.34 / $27.63 / $46.05
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $19.00 / $46.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $20.14 / $57.00