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Georgia rates for HCPCS Q5120

Injection Pegfilgrastim-Bmez (Ziextenzo) Biosimilar 0.5 Mg (Desc Revised 04/01/23)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.99 / $30.32 / $64.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.39 / $30.32 / $33.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.32 / $49.36 / $111.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $30.92
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.32 / $30.32 / $59.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.58 / $23.58 / $30.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $30.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.71 / $837.00 / $1,297.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $32.14 / $38.81