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South Carolina rates for HCPCS Q5104

Injection Infliximab-Abda Biosimilar (Renflexis) 10 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.35 / $3,955.53 / $8,227.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $28.35 / $36.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.96 / $99.42 / $186.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $28.64 / $76.84
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.35 / $34.02 / $90.41
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.27 / $69.27 / $69.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $27.00