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New York 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 $56,234 · 10th–90th $54,954–$91,2010%50%10th90th$56,234Professionalmedian $53,703 · 10th–90th $52,481–$64,5650%50%10th90th$53,703$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$54,954.09 / $54,954.09 / $91,201.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54,954.09 / $54,954.09 / $64,565.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $58,884.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $56,234.13
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52,480.75 / $52,480.75 / $54,954.09
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52,480.75 / $52,480.75 / $52,480.75
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54,954.09 / $74,131.02 / $85,113.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $66,069.34
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52,480.75 / $69,183.10 / $190,546.07
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53,703.18 / $53,703.18 / $72,443.60
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54,954.09 / $54,954.09 / $56,234.13
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54,954.09 / $56,234.13 / $56,234.13
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $141,253.75
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60,255.96 / $60,255.96 / $60,255.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $61,659.50 / $93,325.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52,480.75 / $52,480.75 / $67,608.30
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54,954.09 / $54,954.09 / $64,565.42
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54,954.09 / $56,234.13 / $56,234.13