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North Carolina 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
$432,480.00 / $432,480.00 / $618,369.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453,245.65 / $533,230.17 / $639,876.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$667,854.31 / $983,073.49 / $1,161,131.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563,250.62 / $563,250.62 / $704,063.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,794.80 / $533,794.80 / $639,546.60
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $453,245.65 / $660,676.80
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.38 / $621,609.06 / $709,800.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$853,168.27 / $876,841.03 / $1,021,135.78
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$709,296.75 / $996,193.91 / $996,193.91
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$974,415.94 / $974,415.94 / $974,415.94