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Texas 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
$0.34 / $0.69 / $35.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.33 / $0.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.23 / $0.50
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.33 / $1.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $85.00 / $85.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$850.40 / $850.40 / $850.40
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.39 / $0.68
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.39 / $0.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.49