go back

Utah 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
$85,113.80 / $85,113.80 / $660,693.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,341.33 / $562,341.33 / $676,082.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524,807.46 / $549,540.87 / $660,693.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $44.67 / $60.26
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616,595.00 / $630,957.34 / $630,957.34
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $588,843.66 / $707,945.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,341.33 / $575,439.94 / $616,595.00