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Maryland rates for HCPCS Q2053

Brexucabtagene autoleucel, up to 200 million autologous anti-CD19 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
$448,752.00 / $448,752.00 / $448,752.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $489,304.61 / $513,769.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,720.00 / $489,720.00 / $586,740.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415,908.92 / $489,304.61 / $513,769.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44,944.00 / $44,944.00 / $44,944.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488,038.00 / $488,038.00 / $661,122.00