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Montana rates for HCPCS Q5125

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

Facilitymedian $1 · 10th–90th $0–$64,5650%20%40%10th90th$1Professionalmedian $1 · 10th–90th $0–$20%20%10th90th$1$0.5$5.0$50.0$500.0$5.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.40 / $2.40 / $2.40
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.78 / $46,773.51 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.32 / $0.32 / $0.48
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.56 / $0.56 / $1.62
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.56 / $0.56 / $1.62
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.48
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.32 / $79.43 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.34