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New York rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $66.07 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $41.69 / $7,079.46
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $40.74 / $40.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $39.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $56.23 / $58.88
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $56.23 / $56.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $32.36 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.90
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $43.65 / $114.82
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $34.67 / $58.88
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $40.74 / $40.74
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $40.74 / $40.74
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $58.88
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $47.86 / $47.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $39.81 / $52.48
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $40.74 / $45.71
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $40.74 / $40.74