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Maine rates for HCPCS Q5125

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

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.39 / $1.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.34
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.51