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Virginia 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
$533,230.17 / $559,891.68 / $1,134,930.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $559,891.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.87 / $1.80 / $2.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $716,021.47
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669,102.38 / $761,392.37 / $1,149,010.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $533,794.80 / $639,546.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453,245.64 / $533,230.17 / $604,296.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $559,891.68 / $890,227.77
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530,339.00 / $791,014.00 / $1,078,656.00