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Washington 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
$8.33 / $15.14 / $15.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $8.33 / $9.16
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.77 / $11.96 / $21.92
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $7.97 / $12.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.77 / $6.77 / $13.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $6.77 / $6.77
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.57 / $7.57 / $8.02
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.77 / $14.35 / $21.92
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.14 / $7.17 / $7.97
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.21 / $9.86 / $16.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.57