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Alaska rates for HCPCS Q5125

Injection, filgrastim-ayow, biosimilar, (Releuko), 1 mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $2.19 / $2.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.14 / $2.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.34
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $1.10
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.89 / $1.41
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $0.40 / $0.40
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.63 / $0.63 / $0.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.51 / $1.02