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Idaho rates for HCPCS Q5125

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.41 / $0.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.38
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.50 / $0.67
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.42 / $0.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $78.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.78 / $1.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.42