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Missouri 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
$526,391.00 / $579,414.32 / $724,391.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $573,788.94 / $675,045.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $565,350.88 / $703,172.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536,663.75 / $536,663.75 / $674,814.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$482,927.59 / $675,045.83 / $1,306,934.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984,720.00 / $984,720.00 / $984,720.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630,059.59 / $691,516.23 / $925,940.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62,538.19 / $62,538.19 / $62,538.19