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Virginia rates for HCPCS Q5111

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.65 / $285.70 / $3,613.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $107.40 / $164.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $220.10 / $347.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $142.77
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.36 / $140.69 / $140.69
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.38 / $106.33 / $375.75
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $118.35 / $396.63
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.10 / $240.91 / $609.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $127.60 / $417.50
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $127.60 / $417.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $112.71 / $125.58