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Nebraska rates for HCPCS Q5111

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.04 / $235.03 / $9,673.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $107.40 / $2,969.16
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.04 / $163.25 / $338.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.32 / $120.38 / $120.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.89 / $130.41 / $166.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $196.32 / $340.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.10 / $210.86 / $273.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.04 / $161.88 / $417.50
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.25 / $196.32 / $271.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.25 / $196.32 / $431.05
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.41 / $191.50 / $330.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $126.53