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New York 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
$0.07 / $0.10 / $1.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.08 / $0.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.08 / $0.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.09 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.09
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.21 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.21 / $0.21
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.22
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.22 / $0.22
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.07 / $0.10 / $0.35
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $85.00 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.12
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.45
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.22 / $0.22