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Rhode Island 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
$1,590,240.00 / $1,590,240.00 / $1,590,240.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $489,304.61 / $513,769.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$471,240.00 / $489,720.00 / $517,440.00
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89,304.61 / $89,304.61 / $89,304.61