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Alaska rates for HCPCS Q0161

Chlorpromazine HCl, 5 mg, oral, FDA-approved prescription antiemetic, for use as a complete therapeutic substitute for an IV antiemetic at the time of chemotherapy treatment, not to exceed a 48-hour dosage regimen

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.52 / $1.86 / $1.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.32 / $0.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.53 / $0.76
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.59 / $0.59 / $0.92
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.50 / $0.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.53 / $0.84
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.42 / $0.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.50 / $0.84