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Utah rates for HCPCS Q5125

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.47 / $0.53 / $0.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $0.88 / $1.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.38 / $0.42