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Wyoming rates for HCPCS Q5108

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.71 / $103.71 / $103.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $103.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.44 / $208.75 / $208.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.52 / $93.52 / $93.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $140.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.13 / $99.13 / $110.35