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North Dakota 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 / $30.32 / $50.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $33.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.65 / $26.78 / $27.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.65 / $26.74 / $26.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $30.90 / $35.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.16 / $25.41 / $31.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.99 / $45.48 / $392.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.99 / $31.16 / $33.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $33.75 / $36.65