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Louisiana rates for HCPCS Q5113

Injection, trastuzumab-pkrb, biosimilar, (Herzuma), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $77.62 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $77.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $20.42 / $20.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $20.42 / $20.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $54.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $69.18 / $77.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $54.95 / $74.13