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Arkansas rates for HCPCS Q2041

Axicabtagene ciloleucel, up to 200 million autologous anti-CD19 CAR positive T cells, including leukapheresis and dose preparation procedures, per therapeutic dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$424,000.00 / $613,038.00 / $639,876.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $549,227.07 / $639,876.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,794.80 / $533,794.80 / $639,546.60