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Kentucky rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $44.59 / $6,416.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.70 / $6,300.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.82 / $49.05 / $51.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.61 / $47.51 / $80.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $44.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $54.39 / $64.45
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $44.32 / $62.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $63.75 / $63.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $60.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.90 / $46.82 / $60.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $42.71 / $46.33