go back

Michigan rates for HCPCS Q2042

Tisagenlecleucel, up to 600 million CAR-positive viable T cells, including leukapheresis and dose preparation procedures, per therapeutic dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$609,477.99 / $648,911.00 / $1,156,650.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591,726.19 / $591,726.19 / $615,395.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,558.85 / $816,012.75 / $2,212,428.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$828,416.68 / $828,416.68 / $828,416.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493,816.14 / $542,708.82 / $620,937.13
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591,726.19 / $973,366.00 / $1,388,920.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591,726.19 / $591,726.19 / $710,071.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $636,648.23 / $887,589.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591,726.19 / $591,726.19 / $591,726.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.91 / $244.91 / $244.91