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West Virginia rates for HCPCS Q5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.59 / $44.77 / $49.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $44.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.29 / $41.56 / $60.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $93.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.63 / $63.75 / $63.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $40.29 / $40.29
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.51 / $179.51 / $179.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.29 / $44.32 / $90.47