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HCPCS Q5104

Injection, infliximab-abda, biosimilar, (renflexis), 10 mg

Current codeInjection - Monoclonal Antibodies44 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$67.59 – $119$169 – $298
EvergreenHealth Medical CenterKirkland—$3,696$4,620
Highline Medical CenterBurienFile dated 2026-02-28—$1,435 – $4,099$4,700 – $13,423
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$927 – $1,153$1,325 – $1,647
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$97.77$244
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$68.34 – $79.69$171 – $199
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$91.34 – $96.59$228 – $241
Olympic Medical CenterPort AngelesFile dated 2026-06-24$1,450 – $1,5885 plans$1,171$1,463
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$1,011 – $1,257$1,445 – $1,796
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$1,280$2,462
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$1,011 – $1,257$1,445 – $1,796
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$1,011$1,445
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$1,011$1,445
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$2,068 – $2,164$2,955 – $3,092
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$1,538$2,957
Seattle Children's HospitalSeattle$904 – $1,14312 plans$3,515$3,515
St Anthony HospitalGig HarborFile dated 2026-02-28—$1,430 – $4,083$4,700 – $13,423
St Clare HospitalLakewoodFile dated 2026-02-28—$1,355 – $3,869$4,700 – $13,423
St Elizabeth HospitalEnumclawFile dated 2026-02-28$1,316 – $4,4525 plans$1,661 – $4,743$4,700 – $13,423
St Francis Community HospitalFederal WayFile dated 2026-02-28—$1,475 – $4,213$4,700 – $13,423
St Joseph Medical CenterTacomaFile dated 2026-02-28—$1,557 – $4,446$4,700 – $13,423
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$2,074 – $5,924$4,700 – $13,423
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$941 – $984$1,960 – $2,051
Swedish IssaquahIssaquahFile dated 2026-04-01—$1,224$2,549
Swedish Medical CenterSeattleFile dated 2026-04-01—$984$2,051
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$1,224$2,549
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$67.89 – $91.44$170 – $229
Virginia Mason Medical CenterSeattle—$140$274
Yakima Valley MemorialYakimaFile dated 2026-08-27—$132 – $140$331 – $349

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Hospital outpatient payment (national)
$25.65 (APC 9036)
Surgery center payment (national)
$25.65