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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
$8.77 / $8.77 / $8.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.77 / $8.77 / $8.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.88 / $10.88 / $10.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $6.77 / $6.77
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.21 / $9.40 / $11.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.57