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North Carolina 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
$17,392.16 / $478,157.46 / $628,297.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478,157.46 / $562,538.18 / $655,379.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,074.73 / $1,103,710.37 / $1,568,699.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572,294.27 / $572,294.27 / $715,367.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563,231.27 / $563,231.27 / $674,814.82
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$409,481.04 / $478,157.46 / $696,564.67
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409,481.04 / $656,242.12 / $748,905.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900,061.10 / $925,034.98 / $1,077,260.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630,059.59 / $630,059.59 / $852,129.78
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$748,281.94 / $974,419.42 / $974,419.42
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986,185.70 / $986,185.70 / $986,185.70