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Utah 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
$7.94 / $7.94 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $10.96 / $10.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $8.13 / $12.02
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.76 / $7.76
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.59 / $9.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59