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Missouri 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 / $438.38 / $8,036.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $108.46 / $438.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.04 / $159.16 / $159.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $143.55 / $381.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $107.29 / $136.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.32 / $106.33 / $109.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $135.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.04 / $190.10 / $417.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.04 / $144.19 / $1,358.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.01 / $107.39 / $130.25