go back

Hawaii 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
Professional
Modifier
Low / Median / High Price
$562,341.33 / $562,341.33 / $645,654.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,341.33 / $562,341.33 / $676,082.98
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537,031.80 / $537,031.80 / $537,031.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,341.33 / $676,082.98 / $851,138.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512,861.38 / $549,540.87 / $575,439.94