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Oklahoma rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.59 / $50.09 / $6,878.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $41.10 / $53.95
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.82 / $49.05 / $96.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.35 / $96.78 / $153.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.63 / $34.63 / $40.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.59 / $50.57 / $82.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.59 / $47.27 / $78.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $47.95