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Nebraska rates for HCPCS Q5120

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.59 / $67.02 / $10,562.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $33.17 / $1,060.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.67 / $31.25 / $32.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.60 / $35.32 / $37.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.16 / $30.32 / $31.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.99 / $53.18 / $1,527.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.71 / $27.99 / $33.31
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.65 / $58.07 / $728.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.65 / $33.58 / $777.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $36.08