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Maryland rates for HCPCS Q5120

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.99 / $4,673.97 / $7,356.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $33.92
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.99 / $27.99 / $30.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $31.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $353.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $33.75 / $36.99
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $137.93 / $137.93