go back

Arizona rates for HCPCS Q5103

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.57 / $2,466.67 / $4,933.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.08 / $1,354.37 / $7,469.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.96 / $94.77 / $201.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.75 / $36.00 / $238.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.98 / $19.98 / $19.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.98 / $19.98 / $19.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.14 / $37.72 / $113.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.31 / $41.31 / $41.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.09 / $40.09 / $41.31