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Illinois rates for HCPCS Q5120

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.32 / $55.98 / $4,149.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $46.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.60 / $346.24 / $1,715.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.32 / $30.32 / $30.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $30.32
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $353.30 / $745.34
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.42 / $39.42 / $39.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $32.06 / $40.54