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Hawaii rates for HCPCS Q5105

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.79 / $0.90
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.10 / $1.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.94 / $1.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.19
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.81 / $0.81 / $0.97