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Utah rates for HCPCS Q5103

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.06 / $6,235.02 / $9,625.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.06 / $618.90 / $4,682.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.47 / $14.89 / $20.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.98 / $19.98 / $19.98
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.98 / $19.98 / $68.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.09 / $40.09 / $40.09