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Connecticut rates for HCPCS Q5108

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.09 / $267.89 / $4,852.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.09 / $103.09 / $103.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.07 / $150.69 / $306.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $99.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.13 / $99.13 / $99.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $99.13
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.95 / $91.95 / $108.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.22 / $104.78 / $288.08