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Rhode Island rates for HCPCS Q5111

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$345.57 / $4,050.46 / $6,287.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $110.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.04 / $136.04 / $354.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $106.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $106.33 / $106.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $106.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $118.37