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Iowa 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
$1.33 / $1.66 / $1.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.09
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.72 / $3.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.99 / $1.52
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.84 / $4.47
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $1.11 / $1.52
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.97 / $2.24
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$974.37 / $974.37 / $7,273.11
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.57 / $1.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.94
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.76 / $0.76