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Nebraska 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
$533,230.00 / $979,790.00 / $1,178,650.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $746,522.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491,726.20 / $578,501.41 / $578,501.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621,076.73 / $653,764.98 / $653,953.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503,580.00 / $533,794.80 / $639,546.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $645,208.51 / $853,749.52
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $957,600.00 / $957,600.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$513,993.01 / $559,730.30 / $734,275.73
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492,728.95 / $559,730.30 / $734,275.73
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$622,664.92 / $623,879.30 / $1,087,789.55