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Oklahoma 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
$541,636.00 / $568,717.00 / $812,454.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $568,163.56 / $655,379.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23,717.85 / $37,409.98 / $59,097.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$541,635.66 / $815,680.38 / $1,014,337.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984,720.00 / $984,720.00 / $984,720.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$852,129.78 / $852,129.78 / $852,129.78