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New Mexico 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
$1,659,586.91 / $1,659,586.91 / $1,949,844.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,341.33 / $562,341.33 / $616,595.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549,540.87 / $549,540.87 / $660,693.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575,439.94 / $575,439.94 / $575,439.94
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.31 / $575,439.94 / $977,237.22
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023,292.99 / $1,023,292.99 / $1,023,292.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,341.33 / $562,341.33 / $562,341.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575,439.94 / $575,439.94 / $575,439.94