go back

South Carolina rates for HCPCS Q5125

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.41 / $1.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.40 / $2.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.85 / $1.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.45 / $0.63
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.42 / $1.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.36 / $0.47