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Louisiana 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 / $698,710.00 / $1,614,070.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $655,379.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563,231.27 / $563,231.27 / $674,814.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630,059.59 / $630,059.59 / $630,059.59