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Tennessee rates for HCPCS Q5120

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.99 / $36.39 / $1,543.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $33.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.71 / $30.32 / $30.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $30.32
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$392.55 / $1,527.75 / $1,527.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $32.14 / $235.53