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New Hampshire rates for HCPCS Q5123

Injection, rituximab-arrx, biosimilar, (Riabni), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.92 / $29.92 / $35.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.51 / $26.51 / $36.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.26 / $41.36 / $109.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.51 / $26.51 / $26.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.83 / $26.51 / $26.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.51 / $26.51 / $26.51
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.51 / $26.51 / $44.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.51 / $26.51 / $29.51
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.12 / $80.43 / $102.37