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Sipuleucel-T (Provenge) Autologous Cell Infusion

West 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

Rates data updated July 2026.

How much does Provenge (sipuleucel-t) cost?

$56,234

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $56,234 for this service. The price depends on where it is billed: about $56,234 from a physician practice, and about $56,234 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$56,234$56,234 to $57,544
FacilityA hospital or hospital-owned outpatient department$56,234$56,234 to $74,131

How much rates vary

Facilitymedian $56,234 · 10th to 90th $56,234 to $74,131Professionalmedian $56,234 · 10th to 90th $56,234 to $60,256
$100K$200Kfacility $56,234professional $56,234

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$56,234.13
Median
$56,234.13
Typical High
$56,234.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56,234.13
Median
$56,234.13
Typical High
$58,884.37
CareSource
Setting
Facility
Modifier
Global
Typical Low
$54,954.09
Median
$54,954.09
Typical High
$54,954.09
CareSource
Setting
Professional
Modifier
Global
Typical Low
$54,954.09
Median
$54,954.09
Typical High
$54,954.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$70,794.58
Median
$74,131.02
Typical High
$83,176.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$56,234.13
Median
$56,234.13
Typical High
$239,883.29
United
Setting
Facility
Modifier
Global
Typical Low
$56,234.13
Median
$56,234.13
Typical High
$89,125.09
United
Setting
Professional
Modifier
Global
Typical Low
$52,480.75
Median
$57,543.99
Typical High
$64,565.42

Where West Virginia sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

West Virginia· 33rd of 51

$56,234

MN $63,096NY $53,703

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.