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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
$7.57 / $7.57 / $13.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $9.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.97 / $7.00 / $7.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.92 / $6.99 / $7.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.57 / $7.57 / $8.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.73 / $9.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.57 / $7.97 / $22.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $8.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.43 / $7.57 / $8.48