go back

New Mexico 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
$1.18 / $1.18 / $1.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.04 / $6.27 / $9.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.88 / $1.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.94 / $1.12 / $1.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $0.99 / $1.17
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.84