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Maine 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
$8.16 / $18.21 / $19.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.84 / $8.17 / $9.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.60 / $9.53 / $24.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $7.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.47 / $7.85 / $7.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $7.85
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $9.51
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.21 / $18.21 / $19.63
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.92 / $8.58 / $10.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $13.74