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Vermont 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
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $2.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.90
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.31
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.84 / $1.83