go back

Nebraska rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.04 / $252.10 / $289.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $2,356.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.36 / $141.06 / $148.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.81 / $159.24 / $161.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $136.76 / $170.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.38 / $132.04 / $671.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.04 / $134.25 / $159.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.64 / $175.52 / $287.33
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.71 / $161.10 / $287.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $156.08