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Minnesota rates for HCPCS Q5108

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.13 / $99.13 / $4,518.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $107.06 / $4,500.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.46 / $245.59 / $547.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.97 / $103.71 / $122.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.81 / $126.24 / $423.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.16 / $146.07 / $162.01
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.99 / $100.99 / $139.32
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.99 / $115.01 / $147.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.71 / $184.91 / $331.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.71 / $115.45 / $223.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $110.35 / $183.79