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West Virginia 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
$5.30 / $7.57 / $7.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.64
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.57 / $11.36 / $11.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.77 / $6.77 / $65.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.77 / $6.77 / $10.11
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.98 / $15.98 / $15.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.34 / $7.57 / $10.96