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Colorado rates for HCPCS Q5108

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $3,019.95 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $100.00 / $138.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $194.98 / $316.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $93.33 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $954.99 / $954.99
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $112.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $109.65