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North Dakota 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 / $237.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $131.16 / $159.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.29 / $143.00 / $144.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.95 / $142.79 / $144.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.61 / $133.61 / $153.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.76 / $136.76 / $170.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.04 / $196.74 / $396.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.04 / $149.21 / $162.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.49 / $146.01 / $158.57