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Louisiana 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
$0.79 / $0.81 / $1.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.78 / $0.78 / $1.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $0.78 / $0.80
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.14 / $105.14 / $105.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.79 / $0.85