go back

Delaware rates for HCPCS Q5114

Injection, Trastuzumab-dkst, biosimilar, (Ogivri), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.28 / $40.28 / $46.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.28 / $40.29 / $50.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.43 / $54.43 / $54.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.59 / $44.59 / $202.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $42.71 / $76.90