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Iowa rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $134.90 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $134.90 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $154.88 / $169.82
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $239.88 / $870.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $131.83 / $389.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $138.04 / $173.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $151.36 / $177.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $138.04 / $158.49
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83