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Massachusetts rates for HCPCS Q5111

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.32 / $186.07 / $10,976.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $163.25
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.60 / $317.39 / $1,433.35
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $111.65 / $1,358.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.99 / $130.57 / $239.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $106.33 / $153.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $106.33
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $214.94 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $236.18 / $277.86
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $106.33
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,933.16 / $2,933.16 / $2,933.16
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$417.50 / $1,433.35 / $1,433.35
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $112.71 / $1,358.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $112.71 / $330.12