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Maryland rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.59 / $507.45 / $7,618.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.70 / $4,756.84
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $44.59 / $44.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.84 / $51.84 / $63.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $46.75
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.25 / $40.29 / $81.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $44.85 / $49.15
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.33 / $51.84 / $60.20