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Kansas rates for HCPCS Q5108

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.78 / $2,259.04 / $4,929.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.12 / $107.06 / $2,184.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.99 / $209.18 / $395.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.82 / $111.82 / $111.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.52 / $93.52 / $99.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $99.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.71 / $145.19 / $327.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.71 / $112.90 / $188.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $105.08 / $250.50