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North Dakota rates for HCPCS Q5111

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $106.33 / $244.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.32 / $107.40 / $137.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.36 / $115.94 / $117.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.40 / $115.94 / $117.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.34 / $108.34 / $124.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $166.69 / $211.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.04 / $170.23 / $347.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.04 / $155.09 / $430.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $128.56