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New Mexico 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
$763,474.00 / $763,474.00 / $763,474.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $489,304.61 / $621,416.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,720.00 / $489,720.00 / $586,740.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,399.16 / $797,720.60 / $797,720.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489,304.61 / $503,983.75 / $621,416.85
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552,636.49 / $561,800.00 / $723,032.73