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Kentucky 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
$0.76 / $0.79 / $1.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.93 / $0.93 / $0.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.79 / $0.79
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $0.91 / $1.26
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.87 / $1.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $1.12 / $1.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.84 / $0.89