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Alaska rates for HCPCS Q5103

Injection, infliximab-dyyb, biosimilar, (Inflectra), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.28 / $9,971.33 / $19,326.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.08 / $34.53 / $2,601.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.98 / $19.98 / $19.98
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.17 / $53.17 / $53.17
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.98 / $19.98 / $64.37
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.44 / $158.97 / $249.81
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.10 / $158.97 / $374.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.98 / $19.98 / $21.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.09 / $60.14 / $80.87