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Wyoming 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
$7.57 / $7.57 / $7.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.25 / $13.24 / $13.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.21 / $7.21 / $7.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $10.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $7.85 / $8.74