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North Dakota rates for HCPCS Q5125

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.34 / $0.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.56 / $1.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.46 / $0.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.42 / $0.46