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Montana 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
$562,538.18 / $568,163.56 / $655,379.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563,231.27 / $563,231.27 / $674,814.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,538.18 / $645,607.46 / $680,671.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591,823.04 / $620,071.30 / $656,453.67