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Ohio 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 / $284.62 / $436.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $132.47 / $367.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.65 / $229.07 / $376.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $132.04 / $261.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $131.16 / $229.53
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $177.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.73 / $123.73 / $131.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $524.91
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.01 / $117.01 / $117.01
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $524.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.24 / $167.81 / $191.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $146.01 / $162.55