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Illinois 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
$9.55 / $13.80 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $16.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $35.48 / $173.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $15.49 / $33.88
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
$10.23 / $10.23 / $10.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.76 / $11.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.94 / $9.55