go back

Vermont 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
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $13.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.56 / $9.56 / $14.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $6.77 / $6.77
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.56 / $9.56 / $14.28
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $6.77 / $6.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.05 / $7.57 / $11.65