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Kansas 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
$1.10 / $3.34 / $3.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.80 / $1.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.91 / $0.91 / $0.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.82 / $0.82 / $0.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $2.00 / $2.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $1.00 / $1.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.83 / $4.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.82 / $0.89