go back

Iowa rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.07 / $289.92 / $490.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $2,056.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.61 / $133.61 / $133.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.76 / $154.99 / $170.95
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $239.43 / $840.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.04 / $158.44 / $392.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.04 / $145.24 / $175.52
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.64 / $175.52 / $287.33
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.38 / $161.10 / $287.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $135.09 / $156.08
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.04 / $132.04 / $132.04
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.04 / $132.04 / $132.04