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Virginia 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 / $151.40 / $301.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $132.47 / $137.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $276.75 / $445.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.88 / $123.90 / $186.97
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 / $131.16
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.49 / $157.38 / $392.50
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $131.16 / $209.75
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.60 / $158.69 / $372.88
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.60 / $158.69 / $372.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $139.03 / $170.51