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North Dakota 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
$562,341.33 / $562,341.33 / $1,023,292.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,341.33 / $562,341.33 / $707,945.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524,807.46 / $537,031.80 / $676,082.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537,031.80 / $851,138.04 / $1,023,292.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977,237.22 / $977,237.22 / $977,237.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,341.33 / $562,341.33 / $562,341.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61,659.50 / $512,861.38 / $851,138.04