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New Jersey rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$924.23 / $2,073.60 / $3,502.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $78.40
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.82 / $46.82 / $53.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $48.94 / $63.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.01 / $39.83 / $63.75
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.02 / $170.93 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.35 / $49.43 / $49.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $42.51 / $49.37