go back

Nebraska rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $78.03 / $94.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $50.37 / $6,134.28
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.51 / $78.03 / $96.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.78 / $45.62 / $45.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.95 / $49.42 / $54.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $59.10 / $77.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.43 / $69.11 / $93.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.59 / $47.27 / $90.47
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.51 / $63.10 / $111.97
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.51 / $59.10 / $111.48
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.12 / $62.80 / $82.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $47.95