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Oklahoma rates for HCPCS Q5108

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.06 / $2,760.73 / $3,916.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.06 / $107.06 / $110.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.70 / $193.51 / $306.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.52 / $93.52 / $99.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $99.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.71 / $117.60 / $417.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.71 / $109.93 / $115.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $110.35