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Hawaii rates for HCPCS Q5108

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.12 / $100.12 / $2,757.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $99.13
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.94 / $182.94 / $182.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.04 / $118.95 / $138.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.35 / $148.69 / $150.36
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.71 / $136.54 / $447.94