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New York 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
$7.59 / $11.48 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.59 / $389.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.51
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.13 / $8.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $6.92 / $11.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.59 / $33.11
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.51 / $9.77 / $25.12
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $8.51 / $9.77
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.76 / $7.76 / $8.32
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $7.76 / $7.76
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.77 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.94 / $12.30
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.76 / $7.76 / $8.91
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $7.76 / $9.33