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Rhode Island rates for HCPCS Q5120

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.54 / $98.54 / $2,145.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.62 / $31.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.41 / $27.99 / $333.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $30.32
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 / $30.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $33.75