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Alaska rates for HCPCS Q5111

Injection, pegfilgrastim-cbqv (Udenyca), biosimilar, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $1,047.13 / $18,620.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $162.18 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $194.98 / $407.38
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $194.98 / $407.38
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $588.84 / $912.01
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $501.19 / $501.19
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $194.98 / $457.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $186.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $245.47 / $457.09