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Idaho rates for HCPCS Q5104

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.05 / $25.05 / $6,960.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $29.70 / $33.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.65 / $27.00 / $27.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $27.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.70 / $35.78 / $48.26
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $33.75
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.00 / $27.12 / $71.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $32.40 / $32.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $27.00