Remicade (infliximab) cost per infusion and what the patient owes

Medicare Part B pays for Remicade at ASP+6% — $31.479 per 10 mg billing unit for Q3 2026. Once the $283 Part B deductible is met, the patient owes the remaining 20% coinsurance on the drug and its administration, with no annual out-of-pocket maximum to cap it. Full explanation: How Medicare Part B drug cost sharing works →

What vial rounding adds

Infliximab is dosed by weight and supplied in 100 mg single-dose vials, so an order rarely lands on a row of that table. The claim is built from the vials opened rather than the milligrams infused, and the patient’s 20% is calculated on what is billed. Rounding up to the next whole vial is a real line on the bill, and it is the one figure here that moves without the dose changing.

The 84 kg and 96 kg patients owe the same $314.79, because both orders draw five vials. Across that weight range the drug coinsurance rises in two steps of $62.96 — 20% of one vial — rather than smoothly with weight. A weight recorded in pounds, or a dose rounded in the chart instead of at the vial, can therefore move the bill by a whole step. The discarded milligrams are billed on their own line with the JW modifier: how the units and the JW/JZ line are built →

For the reference patient — 80 kg, 5 mg/kg, 40 units, drug + both infusion codes — Medicare allows $1,420.82, and the Part B coinsurance on that is $284.16. Plans A, B, C, D, F, G, M and N cover Part B coinsurance in full, so after the deductible they leave a Remicade patient nothing to pay at the chair. Plans K and L are the exceptions, and on a weight-dosed drug their balance is not one fixed number: the $142.09 Plan K figure below belongs to this 80 kg reference patient, and a heavier patient on the same 5 mg/kg regimen draws more vials and owes more — at every infusion, eight weeks apart, for as long as maintenance continues. See what each Medigap plan (A–N) owes on this claim →

Only the letters that leave this patient a balance are listed. The full A–N grid, the high-deductible variants, Plan N’s office-visit carve-out and the MACRA restriction on Plans C and F are at Medigap Plans A–N.

Commercial payers negotiate their own rate for J1745, not ASP+6% — our corpus holds published rates from 37 payers, including Aetna, UnitedHealthcare, Cigna, Anthem, Regence, Premera and Kaiser. Aetna’s median is $32.75 per 10 mg unit against Medicare’s $31.479, putting a 400 mg dose at $1,310.00 before benefits. Rates move by state as well as by payer, which is why the estimator above takes one. What the patient owes then depends on their specific benefits. Full explanation: How commercial drug reimbursement works →

Q5109 (the infliximab-qbtx biosimilar) has no entry in the Q3 2026 Medicare ASP file and is omitted from this table.

Medicare pays the same ASP+6% rate for the Remicade drug itself no matter where it's infused. The difference is what gets billed alongside it: an office infusion bills the physician fee schedule's administration codes (96413/96415) and, when documented, a separate office visit (99214) — the codes used in the estimator above — while a hospital outpatient department bills its own facility fee under the hospital outpatient prospective payment system instead of those physician-fee-schedule codes. Our data doesn't carry a Remicade-specific hospital-outpatient facility rate, so this estimator only prices the office/physician-fee-schedule path.

On a commercial plan, J&J withMe takes the drug copay down to as little as $5 per infusion — on the 400 mg example above, that is the difference between the coinsurance the estimator shows and almost nothing. It does not touch the administration or office-visit lines.

On Medicare it does not apply at all, and no diagnosis-matched foundation fund is open for infliximab today. See every program for this patient, with current status →

Sources: CMS ASP pricing files (Q3 2026); Medicare physician fee schedule (96413, 96415, 99214, national non-facility); Medicare Part B deductible (2026); Medicare Rights Center 2026 Medigap plan benefits chart; 37 commercial payer published price files (Q2 2026); J&J withMe and foundation fund terms and status (public/programs-bundle.js, generated from the live programs corpus).

Reviewed September 10, 2026 by Erin Rose, CareCost Estimate founder. Methodology →