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Arizona rates for HCPCS Q0164

Prochlorperazine maleate, 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
$0.36 / $0.69 / $1.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.34 / $0.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $1.10 / $1.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.33 / $0.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.40 / $0.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.35 / $42.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.34