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Montana 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

Facilitymedian $60,256 · 10th–90th $46,774–$107,1520%20%40%10th90th$60,256Professionalmedian $54,954 · 10th–90th $54,954–$69,1830%50%90th$54,954$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54,954.09 / $54,954.09 / $67,608.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $64,565.42 / $141,253.75
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $64,565.42
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40,738.03 / $58,884.37 / $123,026.88
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40,738.03 / $58,884.37 / $123,026.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $60,255.96 / $102,329.30
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $61,659.50 / $75,857.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52,480.75 / $54,954.09 / $57,543.99