| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.64 | $1.64 | $1.64 | |
Aetna
| Professional | $0.33 | $0.35 | $0.35 | |
Cigna
| Professional | $0.35 | $0.35 | $0.35 | |
United
| Professional | $0.34 | $0.34 | $0.68 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.64 | $1.64 | $1.64 | |
Aetna
| Professional | $0.33 | $0.35 | $0.35 | |
Cigna
| Professional | $0.35 | $0.35 | $0.35 | |
United
| Professional | $0.34 | $0.34 | $0.68 |