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Colorado rates for HCPCS M0250

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, second dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.00 / $450.00 / $459.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.00 / $450.00 / $450.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.73 / $371.73 / $371.73
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.00 / $450.00 / $643.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.09 / $758.09 / $1,695.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$554.28 / $708.95 / $1,095.64