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Minnesota 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
$0.41 / $0.41 / $0.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.34 / $0.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.98 / $1.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.51 / $0.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.84 / $1.31 / $1.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.45 / $0.52
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.73 / $1.20 / $1.50
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.44 / $0.78
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 / $0.46