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Missouri 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
$499,578.00 / $549,227.07 / $687,493.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $543,894.77 / $639,876.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.91 / $3.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449,341.85 / $458,328.69 / $561,677.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508,615.80 / $508,615.80 / $639,546.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $539,210.22 / $1,120,029.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$957,600.00 / $957,600.00 / $957,600.00