go back

California rates for HCPCS Q2054

Lisocabtagene maraleucel, up to 110 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
$562,538.18 / $1,083,270.00 / $1,237,580.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $655,379.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,005.11 / $562,538.18 / $576,061.21
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.70 / $97.90 / $637,620.50
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569,956.43 / $573,152.11 / $1,218,334.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563,231.27 / $563,231.27 / $674,814.82
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86,073.71 / $516,485.97 / $697,256.06
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506,284.37 / $675,045.83 / $984,441.83
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$686,965.70 / $939,176.70 / $974,419.42
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984,720.00 / $986,185.70 / $986,185.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531,980.54 / $697,256.05 / $1,058,796.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,538.18 / $585,039.71 / $984,441.83
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591,823.04 / $620,071.30 / $666,576.64
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450,030.55 / $562,538.18 / $843,807.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62,538.19 / $62,538.19 / $62,538.19