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South Dakota 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

Facilitymedian $0 · 10th–90th $0–$00%50%10th90th$0Professionalmedian $0 · 10th–90th $0–$00%20%10th90th$0$0.1$0.2$1.0$5.0$20.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.24 / $0.25 / $8.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.09 / $0.38 / $0.47
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $0.11 / $0.33
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $64.57
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.98 / $1.51
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $0.79 / $0.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.21 / $0.21 / $0.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $0.11
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.06 / $0.06 / $0.06
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.06 / $0.06 / $0.06