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California 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
$0.08 / $0.21 / $11.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.08 / $0.09 / $0.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.09 / $0.18
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.14
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.20
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $393.93 / $801.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.58 / $64.58 / $64.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.08 / $60.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.10 / $0.97
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.09 / $0.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.15