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Hawaii 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
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.50 / $472.50 / $590.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.75 / $567.00 / $661.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.09 / $734.76 / $784.62