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North Carolina rates for HCPCS Q5120

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.06 / $3,013.68 / $9,696.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $80.06 / $473.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.82 / $46.09 / $65.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.41 / $26.41 / $26.41
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 / $392.55
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.08 / $80.06 / $431.81
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.94 / $89.94 / $89.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $32.14 / $40.02
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$392.55 / $392.55 / $1,527.75