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South Dakota 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
$537,031.80 / $537,031.80 / $1,071,519.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $602,559.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501,187.23 / $512,861.38 / $630,957.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $1.48 / $977,237.22
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $954,992.59 / $954,992.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524,807.46 / $562,341.33 / $630,957.34
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588,843.66 / $588,843.66 / $588,843.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $562,341.33