Injection, Tixagevimab And Cilgavimab, For The Pre-Exposure Prophylaxis Only, For Certain Adults And Pediatric Individuals (12 Years Of Age And Older Weighing At Least 40kg) With No Known Sars-Cov-2 Exposure, Who Either Have Moderate To Severely Compromise in Pennsylvania
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in Pennsylvania
| Provider | Medicare | Services |
|---|---|---|
| Gosai, Jayesh M.D. | $0.01 | 16 |
Pennsylvania Pricing in Context
In Pennsylvania, CPT code Q0221 (Injection, Tixagevimab And Cilgavimab, For The Pre-Exposure Prophylaxis Only, For Certain Adults And Pediatric Individuals (12 Years Of Age And Older Weighing At Least 40kg) With No Known Sars-Cov-2 Exposure, Who Either Have Moderate To Severely Compromise) carries an average Medicare payment of $0.01 — 1% above the national benchmark of $0.01. 2 providers across the state submitted claims for this procedure in 2023, performing 17 total services. Individual payments in PA ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.
The average billed charge in Pennsylvania is $26.48, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Pennsylvania sits above the national Medicare average, commercial rates in the state may also run higher than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Temporary Codes procedures, the estimated commercial insurance price in Pennsylvania lands near $0.02, with self-pay cash prices typically around $7.29. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does Injection, Tixagevimab And Cilgavimab, For The Pre-Exposure Prophylaxis Only, For Certain Adults And Pediatric Individuals (12 Years Of Age And Older Weighing At Least 40kg) With No Known Sars-Cov-2 Exposure, Who Either Have Moderate To Severely Compromise cost in Pennsylvania?
The average Medicare payment for Injection, Tixagevimab And Cilgavimab, For The Pre-Exposure Prophylaxis Only, For Certain Adults And Pediatric Individuals (12 Years Of Age And Older Weighing At Least 40kg) With No Known Sars-Cov-2 Exposure, Who Either Have Moderate To Severely Compromise in Pennsylvania is $0.01, which is 1% above the national average of $0.01. Providers in PA typically bill $26.48 for this procedure.
What does Injection, Tixagevimab And Cilgavimab, For The Pre-Exposure Prophylaxis Only, For Certain Adults And Pediatric Individuals (12 Years Of Age And Older Weighing At Least 40kg) With No Known Sars-Cov-2 Exposure, Who Either Have Moderate To Severely Compromise cost with insurance in Pennsylvania?
With commercial insurance in Pennsylvania, Injection, Tixagevimab And Cilgavimab, For The Pre-Exposure Prophylaxis Only, For Certain Adults And Pediatric Individuals (12 Years Of Age And Older Weighing At Least 40kg) With No Known Sars-Cov-2 Exposure, Who Either Have Moderate To Severely Compromise costs an estimated $0.02. Without insurance, the estimated cash price is $7.29. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Injection, Tixagevimab And Cilgavimab, For The Pre-Exposure Prophylaxis Only, For Certain Adults And Pediatric Individuals (12 Years Of Age And Older Weighing At Least 40kg) With No Known Sars-Cov-2 Exposure, Who Either Have Moderate To Severely Compromise in Pennsylvania?
2 providers in Pennsylvania billed Medicare for Injection, Tixagevimab And Cilgavimab, For The Pre-Exposure Prophylaxis Only, For Certain Adults And Pediatric Individuals (12 Years Of Age And Older Weighing At Least 40kg) With No Known Sars-Cov-2 Exposure, Who Either Have Moderate To Severely Compromise in 2023, performing 17 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Injection, Tixagevimab And Cilgavimab, For The Pre-Exposure Prophylaxis Only, For Certain Adults And Pediatric Individuals (12 Years Of Age And Older Weighing At Least 40kg) With No Known Sars-Cov-2 Exposure, Who Either Have Moderate To Severely Compromise cheaper in Pennsylvania than the national average?
No — Injection, Tixagevimab And Cilgavimab, For The Pre-Exposure Prophylaxis Only, For Certain Adults And Pediatric Individuals (12 Years Of Age And Older Weighing At Least 40kg) With No Known Sars-Cov-2 Exposure, Who Either Have Moderate To Severely Compromise costs 1% above the national average in Pennsylvania. The state average Medicare payment is $0.01 compared to $0.01 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.