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Indiana 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
$0.02 / $1,478,670.00 / $3,750,990.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $618,792.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $562,538.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $843,807.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,538.19 / $562,538.19 / $843,807.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $703,172.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536,663.75 / $563,231.27 / $674,814.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$852,129.78 / $1,032,884.58 / $1,032,884.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62,538.19 / $62,538.19 / $62,538.19