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Michigan 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
$56,930.49 / $56,930.49 / $56,930.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.31 / $55,272.32 / $57,483.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86,509.90 / $161,249.53 / $311,435.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61,607.50 / $67,444.00 / $81,062.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $66,643.80
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51,908.48 / $55,272.32 / $82,908.48
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $66,326.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $61,540.56 / $83,918.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $61,529.70 / $68,544.09