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Wisconsin 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 $2 · 10th–90th $0–$90%10%20%10th90th$2Professionalmedian $0 · 10th–90th $0–$10%50%10th90th$0$0.1$0.2$1.0$5.0$20.0$100.0

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
$1.51 / $6.61 / $10.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.31 / $0.31 / $2.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.47 / $1.15 / $1.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.40 / $0.52
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.33 / $0.35 / $0.46
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.07 / $0.26 / $0.72
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.33 / $0.35 / $0.79
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $41.69
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.39 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.63 / $0.63
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.06 / $0.40 / $0.71
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.36 / $0.71 / $1.15
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.35 / $85.11 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.43 / $41.69
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.55 / $0.59 / $0.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.79 / $0.79 / $1.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.34 / $0.34 / $0.41