go back

Utah 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 $6 · 10th–90th $1–$170%10%10th90th$6Professionalmedian $0 · 10th–90th $0–$00%20%40%10th90th$0$0.1$0.2$1.0$5.0$20.0$100.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $5.89 / $16.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.24 / $0.25 / $0.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.09 / $0.09 / $0.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.56
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.23
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.26 / $0.32 / $0.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $0.08