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Missouri rates for HCPCS Q5104

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.53 / $94.93 / $1,916.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.54 / $32.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.00 / $45.90 / $96.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.05 / $60.90 / $222.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.29 / $25.05 / $28.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.85 / $27.85 / $27.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.95 / $27.00 / $33.02