go back

Washington 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
$650,898.81 / $1,156,650.00 / $1,202,920.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591,726.19 / $597,643.46 / $650,898.81
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$511,072.50 / $977,812.60 / $1,236,795.44
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611,059.93 / $998,477.40 / $998,477.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.81 / $518,262.49 / $620,937.13
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$453,856.60 / $591,726.19 / $970,430.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591,726.19 / $591,726.19 / $739,657.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $50.00 / $75.00
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99,999.00 / $99,999.00 / $99,999.00
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$434,411.62 / $817,716.00 / $1,431,002.99
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$597,640.28 / $624,320.65 / $1,093,895.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591,726.19 / $591,726.19 / $591,726.19
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565,623.80 / $591,726.19 / $591,726.19