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Arizona rates for HCPCS Q2043

Sipuleucel-T, minimum of 50 million autologous CD54+ cells activated with PAP-GM-CSF, including leukapheresis and all other preparatory procedures, per infusion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110,545.00 / $110,545.00 / $110,545.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.31 / $55,272.32 / $66,326.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,740.55 / $174,517.54 / $305,800.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44,942.84 / $51,363.25 / $57,783.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,000.00 / $55,272.32 / $55,272.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $55,272.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54,547.21 / $64,617.60 / $95,533.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,945.97 / $55,945.97 / $77,820.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $58,588.66