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Washington 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 $56,234 · 10th–90th $53,703–$112,2020%50%10th90th$56,234Professionalmedian $54,954 · 10th–90th $54,954–$66,0690%50%90th$54,954$50.0$200.0$1.0K$5.0K$20.0K$100.0K$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
$60,255.96 / $109,647.82 / $138,038.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54,954.09 / $54,954.09 / $67,608.30
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43,651.58 / $70,794.58 / $173,780.08
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $56,234.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54,954.09 / $85,113.80 / $173,780.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $69,183.10
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53,703.18 / $56,234.13 / $77,624.71
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53,703.18 / $54,954.09 / $56,234.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54,954.09 / $60,255.96 / $100,000.00
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $66,069.34 / $177,827.94
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66,069.34 / $66,069.34 / $66,069.34
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54,954.09 / $69,183.10 / $173,780.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $56,234.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $56,234.13 / $56,234.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52,480.75 / $54,954.09 / $60,255.96
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54,954.09 / $54,954.09 / $70,794.58