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Hawaii 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
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $575,888.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $533,794.80 / $639,546.60
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714,695.04 / $714,695.04 / $714,695.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $639,876.21 / $746,522.24