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Maryland 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
$449,246.00 / $449,246.00 / $954,108.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $559,891.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,794.80 / $533,794.80 / $639,546.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453,245.64 / $533,230.17 / $559,891.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44,944.00 / $44,944.00 / $44,944.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,517.20 / $489,517.20 / $719,653.30