go back

Oregon rates for HCPCS M0220

Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known SARS-CoV-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available COVID-19 vaccine is not recommended due to a history of severe adverse reaction to a COVID-19 vaccine(s) and/or COVID-19 vaccine component(s), includes injection and post administration monitoring

Insurance Carrier
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.74 / $395.74 / $395.74
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.60 / $302.83 / $302.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.44 / $390.44 / $2,400,000.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.06 / $364.00 / $418.60