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Montana 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
Professional
Modifier
Low / Median / High Price
$591,726.19 / $591,726.19 / $650,898.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518,262.49 / $518,262.49 / $620,937.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.31 / $591,726.19 / $715,988.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$605,779.36 / $641,967.11 / $663,934.18