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Arkansas rates for HCPCS Q5105

Injection, epoetin alfa-epbx, biosimilar, (Retacrit) (for ESRD on dialysis), 100 units

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$254.40 / $254.40 / $254.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $0.81 / $0.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.81 / $0.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.79 / $1.01