go back

Pennsylvania 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 / $56,505.40 / $147,697.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $58,035.94
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,490.75 / $59,965.26 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57,358.07 / $57,358.07 / $57,358.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52,143.70 / $55,272.32 / $55,272.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $57,358.07
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52,665.14 / $52,665.14 / $74,838.72
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,505.40 / $56,505.40 / $147,697.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,825.05 / $95,494.20
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52,096.70 / $63,167.30 / $117,948.60
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52,143.70 / $55,272.32 / $55,272.32
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $61,578.47
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53,981.46 / $53,981.46 / $62,638.87
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53,981.46 / $53,981.46 / $62,638.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $58,588.66 / $70,748.57