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Tennessee rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.15 / $158.44 / $2,275.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $131.16 / $159.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.01 / $131.16 / $131.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$392.50 / $655.80 / $671.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $139.03 / $267.57