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Louisiana rates for HCPCS Q5104

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.84 / $69.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $27.54 / $30.20
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $22.91 / $23.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $28.84 / $28.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $28.84 / $29.51
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $25.12 / $27.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $27.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $27.54 / $29.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $27.54 / $45.71