go back

Texas 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 / $55,825.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $60,246.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55,408.25 / $149,943.32 / $295,307.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63,228.55 / $63,228.55 / $63,228.55
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $54,404.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,000.00 / $55,272.32 / $55,272.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $55,272.32
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73,522.62 / $276,361.59 / $285,085.50
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245,198.88 / $245,198.88 / $245,198.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55,272.32 / $55,945.97 / $93,154.29
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $56,377.77 / $91,199.33
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54,404.11 / $60,799.56 / $115,459.35
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52,143.70 / $55,272.32 / $94,344.33
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 / $58,588.66 / $61,529.70
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,536.50 / $77,381.25