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New Hampshire 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

Facilitymedian $1 · 10th–90th $1–$40%10%20%10th90th$1Professionalmedian $0 · 10th–90th $0–$00%50%10th90th$0$0.1$0.2$1.0$5.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.86 / $3.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.12 / $1.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.48 / $0.71 / $1.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.40 / $0.69 / $0.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $0.35
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $0.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.26 / $0.35 / $0.35
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.34 / $0.51 / $0.66