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Utah rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.13 / $152.13 / $153.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.13 / $152.13 / $152.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.88 / $156.41 / $191.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.52 / $188.65 / $414.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.60 / $131.16 / $146.01