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New Hampshire rates for HCPCS Q5108

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

Facilitymedian $166 · 10th–90th $100–$4,2660%10%20%10th90th$166Professionalmedian $100 · 10th–90th $79–$1480%20%10th90th$100$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$100.00 / $117.49 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $102.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $208.93 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $158.49 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $131.83 / $151.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $100.00 / $245.47