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Oklahoma rates for HCPCS Q5104

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.05 / $27.06 / $46.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.16 / $29.16 / $29.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.49 / $97.72 / $152.05
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 / $27.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.05 / $28.41 / $90.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.05 / $25.05 / $27.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $27.00