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Wyoming 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 / $7,079.46 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $204.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $389.05 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $165.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $48.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $131.83