go back

Vermont rates for HCPCS Q5125

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.43 / $0.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.38
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.43 / $0.71
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.40 / $0.55