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Arizona rates for HCPCS Q0169

Promethazine HCl, 12.5 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
$0.11 / $0.20 / $8.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.07 / $0.26 / $0.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.08 / $0.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.09 / $1.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $64.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.08