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New Hampshire rates for HCPCS Q5125

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

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.89 / $1.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.34 / $0.34
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 / $0.52 / $0.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.38