go back

Arizona 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
$366,000.00 / $878,943.00 / $1,599,690.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $639,876.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.80 / $2.99 / $5.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $0.80 / $0.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508,615.80 / $558,973.80 / $700,937.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $580,634.89 / $959,814.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$957,600.00 / $957,600.00 / $957,600.00