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Ohio rates for HCPCS Q5104

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.57 / $89.91 / $7,321.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.26 / $154.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.16 / $43.47 / $67.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $51.30
Aultcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.18 / $36.18 / $36.18
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.05 / $27.00 / $40.36
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.05 / $27.00 / $36.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.65 / $24.65 / $27.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $120.91
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.76 / $84.64 / $187.12
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $120.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.70 / $34.81 / $39.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $35.15