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Vermont rates for HCPCS Q5122

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $226.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.73 / $151.97 / $200.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.73 / $151.97 / $200.21
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $131.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.60 / $139.03 / $333.63