go back

Texas 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
$0.34 / $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