go back

Idaho rates for HCPCS Q5103

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.68 / $5,479.43 / $8,218.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.81 / $33.89 / $7,469.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.64 / $19.98 / $19.98
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
$21.99 / $26.49 / $35.74
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.98 / $21.99 / $24.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.91 / $15.91 / $15.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.99 / $19.98 / $40.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $40.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.09 / $40.09 / $40.09