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Michigan 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
$506,601.00 / $633,961.00 / $1,083,270.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506,601.00 / $562,538.18 / $613,166.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115,360.88 / $764,584.91 / $2,103,296.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$504,782.88 / $552,604.42 / $717,323.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536,663.75 / $589,798.78 / $674,814.82
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,538.18 / $886,551.00 / $1,356,920.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506,601.00 / $562,538.18 / $675,045.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516,442.29 / $759,426.55 / $843,807.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516,442.29 / $516,442.29 / $516,442.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62,538.19 / $62,538.19 / $62,538.19