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Texas rates for HCPCS Q5125

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.74 / $0.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $1.92 / $3.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.42 / $0.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.38 / $0.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.38
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $85.00 / $85.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.41 / $0.56
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.38 / $0.81
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.38 / $0.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.42 / $0.42
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.45 / $0.51