Pimavanserin (Nuplazid — Parkinson's Disease Psychosis): Cost Across Insurances
Complete cell-by-cell comparison across Self-Pay Cash, Original Medicare, 6 Major California Commercial Payers (Anthem, Blue Shield, UnitedHealthcare, Aetna, Cigna, Kaiser Permanente), and Medi-Cal — with every cell labeled with its official data source and effective date.
Accuracy Level — Tier 1 Published Prices: You are currently viewing general published hospital cash prices, Medicare baselines, and multi-payer ranges. Add your insurance card to unlock Tier 2 plan pricing and Tier 3 verified benefit checks.
Hospital procedure cells are extracted from 14 Bay Area hospital MRFs (45 CFR § 180.50, Oct 2026); medication cells use CMS NADAC (as of 2026-10-28) & CY 2026 Medicare Part D / Medi-Cal Rx rules.
| Parkinson's Service / Medication | Self-Pay / Cash Price Hospital MRF / Retail Cash | Medicare Rate 2026 CMS / NADAC / Part D | Anthem Blue Cross MRF Negotiated / Formulary | Blue Shield of CA MRF Negotiated / Formulary | UnitedHealthcare MRF Negotiated / Formulary | Aetna MRF Negotiated / Formulary | Cigna MRF Negotiated / Formulary | Kaiser Permanente MRF Negotiated / Formulary | Medi-Cal (CA Medicaid) CA DHCS / Medi-Cal Rx |
|---|---|---|---|---|---|---|---|---|---|
MedicationNDC 63090034030 Pimavanserin (Nuplazid — Parkinson's Disease Psychosis) | $5,150 – $5,680 / 30 days (30 capsules) $5,150 – $5,680 / 30 days (30 capsules) Source: CMS NADAC 2026 ($5,114.88 acquisition baseline) & Specialty Pharmacy Cash Benchmarks (Oct 2026) Date: Oct 2026 | NADAC: $5,114.88 / 30 capsules (30-day supply) NUPLAZID 34 MG CAPSULE ($170.49600/EA) • Medicare Part D patient cost: Hits the $2,100 annual Part D out-of-pocket cap on Fill #1 in January (or ~$175/mo with Medicare Prescription Payment Plan smoothing), then $0 for the rest of the year Source: CMS NADAC 2026 (data.medicaid.gov Dataset fbb83258-11c7-47f5-8b18-5f8e79f7e704) & CMS CY 2026 Medicare Part D Protected Class Formulary Rules (Oct 2026) Date: 2026-10-28 | Not published Specialty Tier; Prior Authorization confirming Parkinson's disease psychosis. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Anthem Blue Cross 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Specialty Tier; Prior Authorization confirming Parkinson's disease psychosis. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Blue Shield of CA 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Specialty Tier; Prior Authorization confirming Parkinson's disease psychosis. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: UnitedHealthcare 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Specialty Tier; Prior Authorization confirming Parkinson's disease psychosis. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Aetna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Specialty Tier; Prior Authorization confirming Parkinson's disease psychosis. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Cigna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published RequiresPrior Authorization / Psychiatry or Movement-Disorder Neurology approval (quetiapine or clozapine often trialed first). Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Kaiser Permanente 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | $0 patient copay $0 copay with Medi-Cal Rx Prior Authorization confirming Parkinson's disease psychosis. Source: CA DHCS Medi-Cal Rx Contract Drug List (CDL) & PA Policy Date: Oct 2026 |
Every Insurance Cell for Pimavanserin — With Source & Date Citations
Self-Pay / Discounted Cash Price
$5,150 – $5,680 / 30 days (30 capsules)
Original Medicare (CMS 2026 / NADAC / Part D)
NUPLAZID 34 MG CAPSULE ($170.49600/EA) • Medicare Part D patient cost: Hits the $2,100 annual Part D out-of-pocket cap on Fill #1 in January (or ~$175/mo with Medicare Prescription Payment Plan smoothing), then $0 for the rest of the year
Anthem Blue Cross (California)
Specialty Tier; Prior Authorization confirming Parkinson's disease psychosis. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
Blue Shield of California
Specialty Tier; Prior Authorization confirming Parkinson's disease psychosis. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
UnitedHealthcare (UHC)
Specialty Tier; Prior Authorization confirming Parkinson's disease psychosis. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
Aetna
Specialty Tier; Prior Authorization confirming Parkinson's disease psychosis. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
Cigna
Specialty Tier; Prior Authorization confirming Parkinson's disease psychosis. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
Kaiser Permanente (Northern CA)
RequiresPrior Authorization / Psychiatry or Movement-Disorder Neurology approval (quetiapine or clozapine often trialed first). Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
Medi-Cal (California Medicaid / Medi-Cal Rx)
$0 copay with Medi-Cal Rx Prior Authorization confirming Parkinson's disease psychosis.
Pimavanserin (Nuplazid — Parkinson's Disease Psychosis) — Clinical & Formulary Summary
What it's for: The only FDA-approved medication specifically indicated for hallucinations and delusions associated with Parkinson's disease psychosis — works on serotonin 5-HT2A receptors without blocking dopamine receptors or worsening motor symptoms. (Source: FDA Prescribing Information (NDA 207318) & Parkinson's Foundation)