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Kentucky 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
$0.33 / $1.28 / $1.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $0.53 / $0.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.44 / $0.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.39 / $0.45
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.34 / $0.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.35 / $0.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.43