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Montana rates for HCPCS Q5101

Injection, filgrastim-sndz, biosimilar, (Zarxio), 1 mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$419.97 / $1,373.13 / $1,624.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.46 / $434.26
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
$0.38 / $0.38 / $1.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.46 / $0.46
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.38 / $1.42
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.49 / $0.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.46 / $0.46