go back

North Dakota 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 / $80.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.28 / $40.70 / $54.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.44 / $39.64 / $40.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.64 / $39.64 / $40.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.27 / $48.27 / $55.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $47.70 / $60.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.59 / $60.44 / $82.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.59 / $50.39 / $233.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $50.23