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Tennessee rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $812.71 / $9,869.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $41.50 / $4,650.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.59 / $46.82 / $53.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.77 / $47.48 / $53.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $40.29 / $51.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.64 / $382.05 / $382.05
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.90 / $229.91 / $233.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.28 / $40.29 / $47.95