go back

New Hampshire rates for HCPCS Q5120

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $144.54 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $131.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $316.23 / $524.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $120.23 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $120.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $199.53 / $229.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $263.03