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Idaho rates for HCPCS Q5121

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $20.89 / $2,231.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.28 / $31.39 / $38.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.05 / $20.41 / $20.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.41 / $20.41 / $20.41
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.45 / $27.04 / $36.47
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.41 / $20.41 / $25.51
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.23 / $20.41 / $42.50
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.13 / $24.49 / $24.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.68 / $34.68 / $34.68