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Illinois rates for HCPCS Q5106

Injection Epoetin Alfa-Epbx Biosimilar (Retacrit) (For Non-Esrd Use) 1000 Units (Desc Rvsd 1/1/20)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.85 / $13.74 / $457.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.84 / $7.85 / $11.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.61 / $36.82 / $182.48
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
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $13.24 / $33.10
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.21 / $10.21 / $10.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $8.30 / $11.84