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Ohio rates for HCPCS Q2055

Idecabtagene vicleucel, up to 510 million autologous B-cell maturation antigen (BCMA) directed CAR-positive T cells, including leukapheresis and dose preparation procedures, per therapeutic dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,341.33 / $1,202,264.43 / $1,548,816.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,341.33 / $562,341.33 / $676,082.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562,341.33 / $724,435.96 / $1,380,384.26
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,341.33 / $562,341.33 / $562,341.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758,577.58 / $758,577.58 / $758,577.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588,843.66 / $933,254.30 / $1,000,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562,341.33 / $562,341.33 / $562,341.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,623.41 / $524,807.46 / $549,540.87