go back

New Jersey rates for HCPCS Q5105

Injection Epoetin Alfa-Epbx Biosimilar (Retacrit) (For Esrd On Dialysis) 100 Units (Desc Rvsd 1/1/20)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $1.33 / $463.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.86
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.40 / $6.40 / $6.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.79
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.28 / $1.28
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $1.65 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.73 / $0.73 / $0.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.83 / $0.95