go back

New Hampshire 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
$7.57 / $9.08 / $1,968.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.84 / $7.85 / $7.85
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.26 / $12.96 / $34.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.85 / $7.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.21 / $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
$8.24 / $12.75 / $24.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $8.32
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.25 / $13.95 / $21.31