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New York 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

Facilitymedian $447 · 10th–90th $427–$1,1750%20%10th90th$447Professionalmedian $447 · 10th–90th $447–$5750%50%90th$447$200.0$1.0K$5.0K$20.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $446.68 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $2,187.76
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $562.34 / $1,174.90
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $776.25 / $1,479.11
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $602.56 / $1,071.52
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,071.52 / $1,479.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $537.03 / $1,174.90
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $426.58 / $426.58
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $426.58 / $1,071.52