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Mississippi rates for HCPCS Q5108

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.12 / $1,742.86 / $3,127.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.12 / $104.08 / $2,452.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.16 / $127.16 / $127.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.13 / $99.13 / $125.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $99.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $103.10 / $143.74