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Ohio 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 $91,201 · 10th–90th $54,954–$186,2090%20%10th90th$91,201Professionalmedian $56,234 · 10th–90th $54,954–$81,2830%50%10th90th$56,234$50.0$500.0$5.0K$50.0K$500.0K

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 / $63,095.73 / $186,208.71
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
$60,255.96 / $104,712.85 / $288,403.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56,234.13 / $64,565.42 / $95,499.26
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54,954.09 / $54,954.09 / $54,954.09
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54,954.09 / $54,954.09 / $74,131.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54,954.09 / $112,201.85 / $186,208.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $77,624.71
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $54,954.09 / $54,954.09
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54,954.09 / $54,954.09 / $77,624.71
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54,954.09 / $60,255.96 / $79,432.82
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52,480.75 / $61,659.50 / $107,151.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $123,026.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52,480.75 / $57,543.99 / $63,095.73