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New Hampshire 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

Facilitymedian $0 · 10th–90th $0–$1,122,0180%20%10th90th$0Professionalmedian $562,341 · 10th–90th $562,341–$645,6540%50%90th$562,341$0.0$0.5$10.0$200.0$5.0K$100.0K$2.0M

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562,341.33 / $676,082.98 / $1,122,018.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562,341.33 / $562,341.33 / $645,654.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $0.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562,341.33 / $562,341.33 / $562,341.33
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562,341.33 / $562,341.33 / $758,577.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851,138.04 / $851,138.04 / $851,138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61,659.50 / $61,659.50 / $549,540.87
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478,630.09 / $537,031.80 / $588,843.66