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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
Facility
Modifier
Low / Median / High Price
$0.80 / $0.80 / $0.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.52 / $2.09 / $3.20
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.86 / $1.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.76 / $0.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.79 / $0.88