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Nebraska 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 / $14.55 / $16.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $12.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.43 / $8.14 / $8.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.14 / $8.48 / $8.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $7.73 / $9.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $7.30 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $8.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $9.08 / $11.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $9.08 / $11.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.19 / $7.57 / $8.28