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Iowa rates for HCPCS Q5104

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $42.66 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $128.82 / $5,011.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $33.11 / $35.48
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $83.18 / $169.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $30.20 / $91.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $25.12 / $54.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $54.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $28.84
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $26.92 / $26.92