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California rates for HCPCS Q5125

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.15 / $2.19 / $2.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.40 / $2.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.37 / $0.45 / $0.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.45 / $1.23
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.62 / $0.98
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.44 / $1.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.26 / $0.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.37 / $1.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $85.11 / $85.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.48 / $0.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.32
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.35 / $0.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.36 / $0.91