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New York 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
$0.32 / $0.77 / $3.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.34 / $0.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.34 / $0.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.35 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.35
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.50 / $0.69 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.50 / $0.56
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.51
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.51 / $0.51
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.90
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $85.00 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.52
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.51 / $0.51
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.51 / $0.51