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North Dakota rates for HCPCS Q5113

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $54.95 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $69.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $57.54 / $58.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $57.54 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $83.18 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $56.23 / $72.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $85.11 / $131.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $87.10 / $97.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $54.95 / $54.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $57.54 / $69.18