go back

Pennsylvania 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
$557,317.93 / $1,428,930.00 / $1,645,430.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557,317.93 / $562,891.11 / $654,925.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57,255.43 / $604,637.38 / $755,796.73
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$578,348.80 / $578,348.80 / $578,348.80
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,428,930.00 / $1,645,430.00 / $1,645,430.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557,317.93 / $562,891.11 / $1,645,430.00