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New Mexico 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
$831,066.00 / $831,066.00 / $831,066.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $677,202.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,794.80 / $533,794.80 / $639,546.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502,840.72 / $819,630.40 / $819,630.40
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $538,562.47 / $677,202.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$561,677.31 / $603,408.88 / $768,445.86