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Michigan 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
$480,901.00 / $503,983.75 / $1,444,320.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480,901.00 / $489,304.61 / $513,769.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155,392.49 / $689,177.23 / $1,829,480.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$438,900.00 / $480,480.00 / $623,700.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466,620.00 / $512,820.00 / $586,740.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489,304.61 / $902,700.00 / $1,288,080.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480,901.00 / $489,304.61 / $592,561.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $538,235.07 / $660,688.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.43 / $1.43 / $89,304.61