go back

Iowa rates for HCPCS Q0161

Chlorpromazine Hydrochloride 5 Mg Oral Fda Approved Prescription Anti-Emetic For Use As A Complete Therapeutic Substitute For An Iv Anti- Emetic At The Time Of Chemotherapy Treatment Not To Exceed A 48 Hour Dosage Regimen (Code Deleted 01/01/02 Reinstated 01/01/14) Factor Ix (Antihemophilic Factor Recombinant) Peri.U.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.68 / $1.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.31 / $0.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.72
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $150.00 / $150.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.35 / $2.61
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $850.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $0.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.35
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.35
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.35 / $0.35