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Massachusetts rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $131.16 / $262.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $136.40 / $158.44
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.28 / $351.51 / $655.80
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $139.03 / $333.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.72 / $167.36 / $356.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.01 / $131.16 / $131.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $208.62 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.70 / $193.70 / $227.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $272.39
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$392.50 / $392.50 / $655.80
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $139.03 / $333.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $146.01 / $407.21