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New Hampshire rates for HCPCS Q5103

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $38.90 / $16,218.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $34.67
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $36.31 / $51.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $23.99 / $27.54
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $43.65 / $50.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $39.81 / $61.66