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Maine 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
Professional
Modifier
Low / Median / High Price
$489,304.61 / $508,876.79 / $592,561.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $489,304.61 / $489,304.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,720.00 / $489,720.00 / $586,740.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $489,304.61 / $489,304.61
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $513,769.84 / $822,730.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89,304.61 / $89,304.61 / $89,304.61