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South Dakota 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 / $557,317.93 / $557,317.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557,317.93 / $557,317.93 / $654,925.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$528,312.38 / $528,312.38 / $660,390.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691,338.73 / $889,933.03 / $1,442,850.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557,317.93 / $557,317.93 / $557,317.93
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$526,228.26 / $554,003.59 / $568,323.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526,228.26 / $554,728.05 / $792,468.64
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$609,895.10 / $609,895.10 / $609,895.10