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South Dakota 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
$55,272.32 / $55,272.32 / $55,272.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,735.11 / $58,092.90 / $72,616.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55,945.97 / $94,548.69 / $111,891.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,945.97 / $62,279.61 / $245,198.88
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57,141.44 / $72,197.45 / $93,496.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41,228.79 / $67,135.17 / $78,234.00
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60,486.69 / $60,486.69 / $63,854.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $65,774.06
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55,945.97 / $55,945.97 / $55,945.97
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,945.97 / $55,945.97 / $55,945.97