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Utah rates for HCPCS Q5101

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $812.83 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.17 / $1.91 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.39 / $0.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.35
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.37 / $0.44 / $0.65
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.36 / $0.59
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.46 / $0.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.39