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Indiana 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
$55,825.05 / $132,037.00 / $132,037.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $56,930.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55,272.32 / $110,544.64 / $133,759.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $77,820.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $82,908.48
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $69,090.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $55,272.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $65,085.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $58,588.66 / $66,326.78