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Oklahoma 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
$1.00 / $1.29 / $1.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.20 / $2.14 / $3.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.85 / $1.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.76 / $1.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.76 / $0.85