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Idaho rates for HCPCS Q5113

Injection Trastuzumab-Pkrb Biosimilar (Herzuma) 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.48 / $77.48 / $89.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.37 / $77.48 / $93.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.71 / $63.71 / $69.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.37 / $69.37 / $69.37
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.30 / $86.71 / $110.99
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.37 / $73.53 / $86.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.84 / $73.91 / $144.12
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.30 / $81.42 / $140.91
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.54 / $83.24 / $83.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.37 / $69.37 / $73.53