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Nebraska 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 / $0.19 / $14.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.05 / $0.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.38 / $1.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.07 / $0.13 / $0.82
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 / $0.81 / $1.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.10 / $1.53
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.12