Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
FILGRASTIM-AYOW 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE
Low
$0
Average
$150
Median
$0
High
$1.0k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
62 hospitals; the 90th percentile is 2319.3× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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62 hospital rates
iThe hospitals that file a Tricare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $992 | $992 | $229 | 23% | — | $763 – $1.2k |
| 2 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 4 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 5 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $247 | $220 | $156 | 71% | — | $16 – $395 |
| 7 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $959 | $963 | $163 | 17% | — | $782 – $1.2k |
| 9 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $1.0k | $1.0k | $238 | 23% | — | $793 – $1.3k |
| 13 | HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LOUISIANA LULING, LA other · outpatient | 1 | $0 | $0 | $0 | 3% | — | $0 – $0 |
| 14 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital City, UT facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital Lehi, UT facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | John Muir Health Walnut Creek, CA other · both | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 17 | John Muir Health Concord, CA other · both | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 18 | Kaleida Health Buffalo, NY fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA other · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | LECONTE MEDICAL CENTER Sevierville, TN fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | METHODIST MEDICAL CENTER OF OAK RIDGE Oak Ridge, TN fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | MID COLUMBIA MEDICAL CENTER Dalles, OR other · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION Morristown, TN fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | Mayo Clinic Health System Sparta, WI professional · fee schedule · outpatient | 1 | $66 | $66 | — | — | — | $66 – $66 |
← Payers reporting HCPCS Q5125 · Snapshot 20261111T120946Z-9134e7f7