go back

West Virginia 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 / $132.04 / $133.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.15 / $131.16 / $180.12
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.16 / $196.74 / $196.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.73 / $131.16 / $333.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $131.16 / $178.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $146.01 / $392.50