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Alabama rates for HCPCS Q5122

Injection Pegfilgrastim-Apgf (Nyvepria) Biosimilar 0.5 Mg (Desc Revised 04/01/23)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $131.16 / $137.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.57 / $459.72 / $7,637.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $331.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $139.03