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New Jersey 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 / $162.41 / $322.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $132.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $171.69 / $222.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.51 / $1,165.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.19 / $134.06 / $134.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$314.20 / $314.20 / $314.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $146.01 / $392.50