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Michigan rates for HCPCS Q5103

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $1,548.82 / $4,786.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $5,754.40
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $23.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $72.44 / $177.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $44.67 / $44.67
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $28.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $23.99
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $104.71 / $6,309.57
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $32.36 / $43.65
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $23.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $19.95 / $23.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $42.66