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Rhode Island rates for HCPCS Q5108

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$322.17 / $322.17 / $2,238.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $100.12 / $103.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.71 / $103.71 / $177.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $99.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.52 / $99.13 / $99.13
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 / $105.08 / $110.35