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Indiana rates for HCPCS Q5120

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.63 / $125.96 / $785.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.62 / $30.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.32 / $60.64 / $80.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.77 / $27.99 / $39.74
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.32 / $30.32 / $45.48
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $37.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.32 / $30.32 / $662.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $917.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $33.75 / $51.54