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South Dakota 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 / $7.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $9.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.73 / $7.73 / $9.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.97 / $12.79 / $20.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $8.33
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.91 / $9.08 / $11.67
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $8.72 / $11.67
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $6.77 / $6.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $9.99
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.57