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Washington, DC rates for HCPCS M0249

Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with COVID-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only, includes infusion and post administration monitoring, first dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.00 / $450.00 / $450.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.00 / $450.00 / $450.00
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.35 / $505.35 / $551.39
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,027.22 / $1,027.22 / $1,027.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.35 / $613.91 / $1,334.93