go back

Michigan 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 / $0.31 / $0.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.31 / $0.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.21 / $0.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.08 / $0.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.37 / $0.60 / $2.15
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.37 / $0.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.35