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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
$537,031.80 / $954,992.59 / $954,992.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $645,654.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $645,654.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457,088.19 / $537,031.80 / $549,540.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $562,341.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501,187.23 / $562,341.33 / $588,843.66
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,778.82 / $489,778.82 / $691,830.97