go back

New Hampshire 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 / $92.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.37 / $69.37 / $78.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.80 / $108.22 / $285.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.37 / $69.37 / $69.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.71 / $69.37 / $69.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.37 / $69.37 / $69.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.37 / $69.37 / $116.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.37 / $69.37 / $73.53
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.37 / $104.91 / $133.52