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South Dakota 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 $0 · 10th–90th $0–$30%20%40%90th$0Professionalmedian $0 · 10th–90th $0–$10%20%10th90th$0$0.1$0.2$1.0$5.0$20.0

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
$2.40 / $2.40 / $2.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.41 / $0.41 / $0.52
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.22 / $0.44 / $0.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $41.69
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.56 / $0.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.27 / $0.27 / $0.27
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.50 / $0.50 / $0.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.46
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $0.35
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $0.35