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Missouri 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
$1.39 / $1.39 / $18.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $0.83 / $2.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.72 / $1.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.91 / $1.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.81 / $4.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.79 / $0.93