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Utah 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 $17 · 10th–90th $3–$500%20%10th90th$17Professionalmedian $0 · 10th–90th $0–$10%20%40%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
$2.69 / $17.38 / $50.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.02 / $27.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $0.35
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.39 / $0.44 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.50 / $0.50 / $0.66
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.23 / $0.28 / $0.52
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.17 / $0.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.34