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Maine rates for HCPCS Q5103

Injection Infliximab-Dyyb Biosimilar (Inflectra) 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.13 / $6,948.67 / $13,489.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.81 / $31.39 / $34.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.34 / $24.28 / $63.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.98 / $19.98 / $19.98
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.98 / $19.98 / $24.21
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.13 / $4,351.50 / $13,489.87
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.81 / $31.39 / $35.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.08 / $40.09 / $70.16