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South Dakota 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
$591,726.19 / $591,726.19 / $591,726.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591,726.19 / $591,726.19 / $591,726.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488,926.88 / $493,816.14 / $611,158.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.31 / $819,013.70 / $1,327,868.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591,726.19 / $998,477.40 / $998,477.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$554,871.41 / $694,525.35 / $848,435.75
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531,417.28 / $607,240.81 / $607,709.68
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$647,549.43 / $647,549.43 / $647,549.43