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New Mexico 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
$844,410.00 / $844,410.00 / $844,410.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $714,423.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563,231.27 / $563,231.27 / $674,814.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516,442.28 / $841,800.94 / $841,800.94
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,538.18 / $573,788.94 / $714,423.49
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591,823.04 / $620,071.30 / $810,882.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516,442.29 / $516,442.29 / $852,129.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62,538.19 / $62,538.19 / $62,538.19