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West Virginia rates for HCPCS Q5104

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.05 / $25.05 / $27.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.26 / $29.99
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.00 / $27.00 / $40.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.60 / $62.60 / $62.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.65 / $27.00 / $76.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $56.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.33 / $41.33 / $41.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $90.41