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Wyoming 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
$1.32 / $436.52 / $3,801.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.32 / $1.32 / $1.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.32 / $1.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.91 / $1.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.76 / $0.81