go back

Oregon rates for HCPCS Q5120

Injection Pegfilgrastim-Bmez (Ziextenzo) Biosimilar 0.5 Mg (Desc Revised 04/01/23)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.99 / $721.20 / $13,148.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $31.54 / $1,667.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.58 / $41.96 / $49.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.12 / $30.32 / $30.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.75 / $61.79 / $71.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.32 / $43.36 / $874.24
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $33.35 / $39.42
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.47 / $30.05 / $61.77
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.94 / $41.96 / $408.91
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $32.90 / $408.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.10 / $317.27 / $862.63
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $30.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $33.75