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Hawaii rates for HCPCS Q5106

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.84 / $8.16 / $502.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $7.85
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.91 / $10.91 / $10.91
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.64 / $9.42 / $10.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.74 / $8.96 / $11.78
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.07 / $9.64 / $15.20