Just because they don't issue a bill doesn't mean they don't track costs. They track labor, labor rates, and consumables.

That said, this particular treatment is very involved. They harvest cells over multiple periods, send them to a lab to be modified, and when they are ready they do chemotherapy to kill your immune system, then do a bone marrow transplant to introduce the modified cells, and then you have to be in isolation in a hospital until your immune system comes back. Even the best facilities are saying they can only do 5-10 of these per year.

Pretty crazy.