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Illinois rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.59 / $70.92 / $6,914.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $41.91 / $6,732.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.59 / $46.82 / $73.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.40 / $203.30 / $969.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.17 / $90.74 / $90.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $56.18
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $69.25 / $195.22
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.38 / $52.38 / $52.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.82 / $65.55 / $70.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $42.71 / $48.75