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Arizona rates for HCPCS Q5104

Injection, infliximab-abda, biosimilar, (Renflexis), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $51.29 / $5,370.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $28.84 / $2,818.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $22.91 / $22.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.55 / $91.20 / $263.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $53.70 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $39.81 / $97.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $25.12 / $25.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $27.54 / $45.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54