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Montana rates for HCPCS Q5108

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

Facilitymedian $240 · 10th–90th $162$7,0790%20%10th90th$240Professionalmedian $110 · 10th–90th $98$4,4670%20%40%10th90th$110$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $6,918.31 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $107.15 / $4,466.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $64,565.42 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $128.82
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $173.78 / $436.52
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $173.78 / $436.52
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $85.11 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00