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Mississippi rates for HCPCS Q0164

Prochlorperazine Maleate 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 (Special Coverage Instructions Apply)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.57 / $0.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.34 / $0.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.35 / $0.35
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.34 / $0.44