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Idaho rates for HCPCS Q5103

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $4,897.79 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $34.67 / $7,413.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.62 / $43.65 / $53.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $39.81 / $53.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $23.99 / $23.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $23.99
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $30.20 / $5,623.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $32.36 / $69.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $23.99 / $47.86
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $28.84 / $39.81
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $26.30 / $26.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81