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West Virginia 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 / $27.99 / $30.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $33.69
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.32 / $45.48 / $45.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.58 / $30.32 / $333.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $30.32 / $498.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $33.75 / $392.55