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Washington 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 $0–$350%10%10th90th$1Professionalmedian $0 · 10th–90th $0–$10%20%10th90th$0$0.1$0.5$5.0$50.0$500.0$5.0K

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
$2.82 / $7.08 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.28 / $0.31 / $0.31
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.50 / $0.50 / $0.50
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.50 / $0.50 / $0.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.68 / $0.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $0.35
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.34 / $0.56 / $0.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.31 / $0.52 / $0.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $0.04 / $0.04
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.35
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $0.35
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.50 / $0.50 / $0.50
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.50 / $0.50 / $0.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.23 / $0.35 / $1.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.35