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Vermont rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.28 / $40.29 / $76.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.63 / $49.33 / $82.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $82.21
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.63 / $49.33 / $82.21
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $82.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $45.55 / $93.09