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New Jersey rates for HCPCS M0221

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 in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the COVID-19 public health emergency

Facilitymedian $6,310 · 10th–90th $5,623$6,3100%50%10th$6,310Professionalmedian $457 · 10th–90th $324$5890%20%40%10th90th$457$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,623.41 / $6,309.57 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $457.09 / $588.84