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Iowa 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
$0.09 / $0.09 / $0.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.38 / $1.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $5.72 / $8.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.09 / $0.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $64.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.98 / $1.53
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.75 / $1.53
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $5.78 / $7.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.09
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.06
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.06