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Idaho 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
$7.57 / $8.71 / $1,873.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.84 / $8.64 / $9.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.21 / $7.21 / $7.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $7.85
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.64 / $10.40 / $14.03
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $8.64 / $9.81
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.50 / $11.63 / $19.50
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.42 / $9.42 / $9.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $10.99