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Michigan rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.09 / $136.00 / $424.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $135.09 / $159.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.13 / $292.08 / $552.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.95 / $133.63 / $133.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $238.00 / $424.32
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $135.09 / $157.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.83 / $151.84 / $154.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $146.01 / $167.91