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Missouri rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.78 / $412.13 / $533.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $133.78 / $160.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $222.97 / $471.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $163.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.73 / $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
$109.12 / $378.45 / $671.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.23 / $132.04 / $165.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.49 / $131.16 / $183.10