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West Virginia 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
$342,804.00 / $342,804.00 / $538,692.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $489,304.61 / $494,197.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489,304.60 / $538,235.10 / $733,956.90
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489,304.61 / $489,304.61 / $1,134,476.31