go back

New Mexico 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
$55,272.32 / $55,272.32 / $55,272.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.31 / $55,272.32 / $70,195.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $187,676.48 / $296,739.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49,480.52 / $53,630.37 / $65,974.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,000.00 / $55,272.32 / $66,147.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $55,272.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,536.50 / $57,202.59 / $92,937.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37,200.00 / $55,272.32 / $77,820.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $69,420.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $58,588.66