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Alaska rates for HCPCS Q5108

Injection, pegfilgrastim-jmdb (Fulphila), biosimilar, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.37 / $475.15 / $8,266.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.12 / $110.13 / $3,511.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $99.13
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.66 / $263.66 / $263.66
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $319.20
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.14 / $292.25 / $459.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.02 / $292.25 / $688.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $107.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.35 / $148.69 / $297.39