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Missouri 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
$462,923.00 / $499,090.70 / $503,983.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $499,090.70 / $587,165.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $491,751.13 / $611,630.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466,620.00 / $466,620.00 / $586,740.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458,428.80 / $629,216.00 / $1,204,499.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$996,400.00 / $996,400.00 / $996,400.00