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Arizona rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.34 / $262.32 / $393.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $144.27 / $2,056.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.93 / $338.52 / $653.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.87 / $127.82 / $834.32
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.66 / $159.76 / $392.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.04 / $132.04 / $145.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $132.04