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New Hampshire rates for HCPCS Q0249

Injection Tocilizumab For Hospitalized Adults 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 Extracor- Poreal Membrane Oxygenation (Ecmo) Only 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.57 / $7.57 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.02 / $13.63 / $34.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $9.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.77 / $6.77 / $6.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $6.77 / $6.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $12.29 / $23.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.57
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.88 / $6.89 / $8.23