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Virginia 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 / $590,665.09 / $1,198,160.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $590,665.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $779,059.13
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679,024.34 / $772,682.87 / $1,166,048.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563,231.27 / $563,231.27 / $674,814.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478,157.46 / $562,538.18 / $637,620.43
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$409,481.04 / $590,665.09 / $939,157.49
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559,147.00 / $833,982.00 / $1,137,248.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516,442.29 / $852,129.78 / $852,129.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62,538.19 / $62,538.19 / $62,538.19