go back

North Carolina rates for HCPCS Q5121

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.04 / $2,798.76 / $9,296.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.28 / $34.04 / $2,925.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.87 / $32.15 / $40.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.75 / $20.75 / $42.00
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 / $60.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.29 / $34.04 / $66.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.50 / $33.50 / $33.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.68 / $34.68 / $45.78
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $257.50