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Montana rates for HCPCS Q5114

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

Facilitymedian $66 · 10th–90th $38–$1350%20%10th90th$66Professionalmedian $38 · 10th–90th $37–$3,2360%50%10th90th$38$50.0$500.0$5.0K$50.0K$500.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15,848.93 / $15,848.93 / $15,848.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $38.02 / $4,168.69
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $229.09 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $53.70
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $67.61 / $112.20
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $67.61 / $112.20
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $46.77 / $83.18
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $53.70 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $46.77