go back

West 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
$379,145.00 / $379,145.00 / $595,799.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $568,163.56
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,538.19 / $618,792.00 / $843,807.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,538.18 / $562,538.18 / $1,304,271.87