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Tennessee 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 / $691,830.97 / $1,621,810.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $588,843.66
BCBS
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
$512,861.38 / $588,843.66 / $645,654.23
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000,000.00 / $1,000,000.00 / $1,000,000.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995,262.31 / $1,995,262.31 / $1,995,262.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501,187.23 / $537,031.80 / $616,595.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,778.82 / $501,187.23 / $575,439.94