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Hawaii rates for HCPCS Q5120

Injection, pegfilgrastim-bmez (ZIEXTENZO), biosimilar, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $41.63 / $7,920.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $30.32
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.86 / $130.86 / $130.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.36 / $36.39 / $42.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.65 / $33.75 / $45.48
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.99 / $116.02 / $387.35