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Texas 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 / $826,378.00 / $1,032,970.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $618,792.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$408,658.80 / $1,001,214.06 / $1,916,609.77
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,201.24 / $562,201.24 / $562,201.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536,663.75 / $563,231.27 / $674,814.82
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$686,965.70 / $939,176.70 / $974,419.42
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984,720.00 / $986,185.70 / $986,185.70
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,538.18 / $590,665.10 / $1,192,580.96
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $573,788.94 / $928,188.01
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,201.24 / $618,792.00 / $787,553.46
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,538.18 / $579,526.84 / $1,596,708.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$586,484.10 / $620,071.30 / $656,453.67
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
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516,486.00 / $541,635.69 / $595,799.30