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Arizona rates for HCPCS Q5121

Injection, infliximab-axxq, biosimilar, (AVSOLA), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.27 / $53.32 / $93.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.02 / $34.20 / $5,714.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.39 / $79.98 / $164.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.59 / $31.90 / $129.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.41 / $20.41 / $20.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.41 / $20.41 / $20.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.50 / $49.05 / $96.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $36.00 / $36.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.68 / $34.68 / $34.68