go back

Oregon 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
$489,720.00 / $489,720.00 / $979,440.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $489,304.61 / $592,561.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466,620.00 / $489,720.00 / $586,740.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.00 / $489,304.61 / $1,027,539.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489,304.61 / $513,769.84 / $1,052,004.90
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $577,379.43 / $636,095.99
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79,999.20 / $99,999.00 / $99,999.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489,304.61 / $561,800.00 / $1,007,967.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498,750.00 / $561,800.00 / $610,064.39