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North Dakota 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 / $0.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.82 / $0.82 / $0.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $0.83 / $0.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.79 / $0.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.83 / $1.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.85 / $1.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.94