go back

Illinois 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
$0.31 / $0.68 / $11.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.31 / $0.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $4.41 / $27.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.65 / $100.00 / $345.40
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.01 / $1,500.00 / $2,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.35