go back

Virginia 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 / $58,035.94 / $58,035.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $58,035.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55,272.32 / $114,413.70 / $180,740.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $74,087.00
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,945.97 / $55,945.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52,143.70 / $52,143.70 / $55,272.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $55,272.32 / $55,272.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46,981.47 / $55,272.32 / $70,038.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37,200.00 / $56,930.49 / $90,635.33
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46,873.00 / $74,974.00 / $94,467.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55,272.32 / $58,588.66 / $65,276.86