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Washington 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
$8.64 / $14.25 / $255.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.84 / $8.64 / $502.43
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.82 / $10.23 / $21.14
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $8.11 / $13.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.21 / $7.47 / $14.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $9.36
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.82 / $7.71 / $14.84
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.04 / $12.90 / $21.91
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.33 / $8.11 / $13.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.82 / $9.75 / $19.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $7.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $9.42