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Texas 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
$489,304.61 / $800,404.00 / $976,103.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $489,304.61 / $538,235.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371,508.00 / $910,194.60 / $1,742,372.52
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $489,450.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466,620.00 / $489,720.00 / $586,740.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$650,867.43 / $890,400.00 / $969,564.37
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$996,400.00 / $996,400.00 / $996,400.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489,304.61 / $513,769.84 / $1,037,325.77
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $499,090.70 / $807,352.61
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $538,395.22 / $685,230.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489,304.61 / $504,081.60 / $1,388,842.21
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498,750.00 / $561,800.00 / $620,313.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89,304.61 / $89,304.61 / $89,304.61
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488,038.00 / $489,720.00 / $538,692.00