go back

Rhode Island rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.94 / $130.94 / $3,877.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $41.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.50 / $44.59 / $63.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $44.85