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Georgia 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
$533,230.17 / $1,055,490.00 / $1,150,570.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $559,891.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.87 / $1.42 / $3.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $543,894.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$533,230.19 / $533,230.19 / $1,045,131.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $533,230.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $0.87 / $0.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,517.15 / $489,517.15 / $734,275.73
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532,192.24 / $735,857.64 / $986,475.82