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Iowa rates for HCPCS Q5120

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.03 / $7,080.44 / $10,562.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $215.86 / $8,352.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $30.90 / $30.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.16 / $29.65 / $31.45
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $239.46 / $627.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.99 / $32.11 / $444.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.99 / $30.79 / $48.74
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.11 / $44.48 / $728.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.17 / $33.58 / $444.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.93 / $36.08
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.99 / $27.99 / $27.99
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.99 / $27.99 / $27.99