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Nebraska rates for HCPCS Q5105

Injection, epoetin alfa-epbx, biosimilar, (Retacrit) (for ESRD on dialysis), 100 units

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $0.89 / $0.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.82 / $0.86 / $0.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.85 / $1.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $1.13 / $1.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.84 / $4.63
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $0.85 / $4.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.97 / $1.89
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,273.11 / $7,273.11 / $7,273.11
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $0.92 / $1.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.94