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North Carolina rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.31 / $549.45 / $3,312.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.31 / $131.16 / $333.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.63 / $257.24 / $345.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.52 / $139.52 / $139.52
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 / $392.50
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.31 / $156.08 / $431.75
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.75 / $274.75 / $274.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $139.03 / $173.13
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$392.50 / $392.50 / $655.80