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Ohio rates for HCPCS Q5108

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

Facilitymedian $200 · 10th–90th $98$5,0120%10%10th90th$200Professionalmedian $100 · 10th–90th $89$2140%20%40%10th90th$100$1.0$5.0$20.0$100.0$500.0$2.0K$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
$117.49 / $251.19 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $100.00 / $213.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $147.91 / $407.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $97.72 / $162.18
Aultcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $147.91 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $208.93
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $194.98 / $389.05
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $281.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $123.03 / $144.54
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $134.90 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $109.65 / $123.03