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Montana 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

Facilitymedian $537,032 · 10th–90th $457,088–$1,122,0180%50%10th90th$537,032Professionalmedian $537,032 · 10th–90th $537,032–$660,6930%50%90th$537,032$0.1$1.0$20.0$500.0$10.0K$200.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537,031.80 / $537,031.80 / $645,654.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537,031.80 / $537,031.80 / $645,654.23
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489,778.82 / $501,187.23 / $1,258,925.41
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489,778.82 / $501,187.23 / $1,258,925.41
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $588,843.66 / $1,096,478.20
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $588,843.66 / $758,577.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501,187.23 / $501,187.23 / $501,187.23