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Kansas rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.18 / $5,635.80 / $18,439.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $44.32 / $3,312.98
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.82 / $46.82 / $46.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.26 / $79.84 / $117.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.45 / $45.45 / $45.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.63 / $40.29 / $120.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.59 / $62.43 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.59 / $49.64 / $233.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $42.71 / $47.95