go back

Washington rates for HCPCS Q5121

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.20 / $42.82 / $54.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.02 / $31.39 / $1,217.61
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.41 / $32.84 / $67.86
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.43 / $21.51 / $60.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.05 / $18.05 / $39.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.41 / $20.41 / $23.48
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.02 / $25.51 / $62.67
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.00 / $45.30 / $71.55
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.45 / $22.81 / $60.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.41 / $22.45 / $43.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.43 / $21.43 / $21.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.68 / $34.68 / $34.68