go back

Tennessee 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
$562,538.18 / $649,963.00 / $1,180,220.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $590,665.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516,442.28 / $562,074.73 / $648,940.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563,231.27 / $571,973.51 / $674,814.82
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$686,965.70 / $748,281.94 / $974,419.42
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984,720.00 / $986,185.70 / $986,185.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516,442.29 / $852,129.78 / $1,110,350.92