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Wisconsin rates for HCPCS Q5101

Inj Filgrastim Gcsf Biosimil

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.47 / $530.54 / $2,962.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.47 / $384.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $0.99 / $1.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.46 / $0.57
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.63 / $0.63 / $0.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.56 / $1.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.50 / $0.56
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.37 / $0.37 / $0.71
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.37 / $0.37 / $0.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.41 / $0.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.46 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.37 / $0.37 / $0.71
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $0.51 / $1.10
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.46 / $85.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.46 / $0.46
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.61 / $0.65 / $1.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.51 / $0.68