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Oklahoma rates for HCPCS Q5111

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.84 / $142.84 / $292.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $108.46 / $164.61
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.04 / $163.60 / $338.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.70 / $193.56 / $306.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.32 / $100.32 / $106.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $106.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.40 / $154.28 / $417.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.49 / $144.19 / $185.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $126.53