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Minnesota 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 / $0.79 / $0.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.73 / $0.76 / $0.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.63 / $0.76 / $0.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.46 / $2.37 / $3.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.79 / $0.90
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.99 / $2.65
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.84 / $1.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.83 / $1.43