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Indiana 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
$7.93 / $20.67 / $617.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.93 / $7.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.85 / $15.70 / $20.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.67 / $7.07 / $10.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.85 / $7.85 / $11.70
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $9.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.85 / $7.85 / $23.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $20.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $8.74 / $12.54