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Arkansas rates for HCPCS Q5108

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.95 / $124.45 / $1,742.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $100.12 / $118.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.45 / $115.45 / $115.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.45 / $115.45 / $122.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.52 / $99.13 / $245.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $99.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $105.08 / $266.16