go back

California 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
$724,435.96 / $1,148,153.62 / $1,819,700.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $1,258,925.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407,380.28 / $537,031.80 / $676,082.98
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $95.50 / $602,559.59
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $616,595.00 / $1,071,519.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512,861.38 / $537,031.80 / $645,654.23
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89,125.09 / $537,031.80 / $724,435.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478,630.09 / $562,341.33 / $933,254.30
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000,000.00 / $1,000,000.00 / $1,000,000.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995,262.31 / $1,995,262.31 / $1,995,262.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.91 / $537,031.80 / $933,254.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $616,595.00 / $851,138.04
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426,579.52 / $588,843.66 / $912,010.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $537,031.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $478,630.09 / $660,693.45