go back

Nebraska rates for HCPCS Q5125

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $302.00 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $467.74 / $524.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.36 / $0.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.37 / $0.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.78 / $85.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.43 / $0.51
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.51 / $0.65 / $0.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.43 / $0.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.51