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Maine 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
Professional
Modifier
Low / Median / High Price
$55,272.31 / $56,930.49 / $58,035.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49,159.20 / $61,446.24 / $175,157.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $57,358.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $66,147.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $55,272.32
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $55,272.32
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.31 / $57,483.22 / $58,035.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $80,144.86