go back

North Dakota rates for HCPCS Q0249

Injection, 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, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $7.08 / $13.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $8.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $6.92 / $7.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $6.92 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $8.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.76 / $9.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $11.48 / $22.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.59 / $8.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $7.59 / $8.51