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Alaska rates for HCPCS Q5122

Injection, pegfilgrastim-apgf (Nyvepria), biosimilar, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.13 / $243.13 / $859.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $131.15 / $243.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$348.85 / $348.85 / $348.85
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $422.34
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.62 / $549.50 / $863.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.14 / $549.50 / $1,295.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $142.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.01 / $196.74 / $393.48