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West 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
$1.38 / $424,000.00 / $424,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $538,562.47
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$533,230.19 / $586,553.19 / $799,845.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533,230.17 / $533,230.17 / $1,236,319.82