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Vermont rates for HCPCS Q5104

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $29.99 / $43.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.65 / $30.66 / $51.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $27.00
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.65 / $30.66 / $51.09
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $27.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $41.53