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Michigan rates for HCPCS Q5111

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.52 / $137.99 / $437.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $107.40 / $154.16
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.04 / $136.04 / $252.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.53 / $231.92 / $441.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.92 / $112.67 / $146.26
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $136.04 / $202.06
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $116.96 / $246.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $211.69
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $273.25 / $417.50
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $109.52 / $154.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $149.64 / $220.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $118.37 / $136.13