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Montana rates for HCPCS J2506

Injection, pegfilgrastim, excludes biosimilar, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,835.73 / $6,835.73 / $6,835.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.34 / $97.38 / $3,343.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.54 / $35.54 / $35.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $89.34 / $89.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.54 / $35.54 / $35.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.38 / $96.93 / $126.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.34 / $89.34 / $89.34