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Minnesota rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.70 / $6,380.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.04 / $54.16 / $161.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.67 / $44.43 / $44.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.75 / $60.34 / $152.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.70 / $51.04 / $63.33
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.27 / $48.27 / $66.15
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.70 / $47.70 / $55.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.59 / $44.59 / $98.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.59 / $49.64 / $114.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $42.71 / $77.08