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Washington rates for HCPCS Q5125

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.40 / $2.40
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $50.12 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.37 / $0.41 / $0.56
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.69 / $1.51
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $0.48 / $0.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.62 / $1.23
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.41
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.44