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Arizona rates for HCPCS Q5106

Injection, epoetin alfa-epbx, biosimilar, (Retacrit) (for non-ESRD use), 1000 units

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.40 / $15.70 / $328.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.84 / $9.89 / $761.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.28 / $25.56 / $41.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $7.33 / $49.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.85 / $7.85 / $7.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $7.85
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.57 / $11.90 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $8.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $7.85