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Rhode Island 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
$1,733,000.00 / $1,733,000.00 / $1,733,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $559,891.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$513,651.60 / $533,076.48 / $563,250.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $533,230.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,794.80 / $533,794.80 / $639,546.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33,230.17 / $33,230.17 / $33,230.17