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Vermont 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
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $645,023.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,794.80 / $533,794.80 / $639,546.60
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,794.80 / $621,609.06 / $639,546.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33,230.17 / $33,230.17 / $33,230.17