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Minnesota rates for HCPCS Q5104

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.00 / $27.00 / $27.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $28.09 / $2,943.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.46 / $51.47 / $101.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.04 / $25.05 / $31.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.02 / $32.22 / $84.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.67 / $32.47 / $36.04
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.53 / $27.53 / $27.93
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.53 / $28.39 / $29.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.05 / $25.05 / $96.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.05 / $25.05 / $45.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $48.95