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Oregon 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 / $203.23 / $264.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $132.47 / $180.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.01 / $198.70 / $268.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $142.29
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.13 / $289.77 / $335.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $187.56 / $431.75
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $144.27 / $170.51
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.15 / $149.47 / $393.48
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.21 / $127.47 / $198.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.23 / $142.29 / $154.66
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.08 / $217.69 / $372.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $146.01