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Missouri rates for HCPCS Q5120

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.92 / $412.18 / $5,839.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.93 / $39.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.32 / $51.54 / $108.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $37.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.58 / $30.32 / $30.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $30.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.99 / $92.00 / $1,527.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.71 / $27.99 / $34.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $32.06 / $42.33