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Wisconsin 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–$60%20%10th90th$0Professionalmedian $0 · 10th–90th $0–$20%20%40%10th90th$0$0.0$0.1$0.5$2.0$10.0$50.0

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
$5.89 / $5.89 / $5.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $10.96 / $14.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $1.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $1.05 / $1.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.09 / $0.44 / $1.29
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $0.08 / $0.33
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $0.08 / $0.33
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $64.57
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.15 / $0.30 / $0.30
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.03 / $0.03 / $0.81
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.72 / $1.45 / $2.29
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $85.11 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.09 / $0.11 / $64.57
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.28 / $0.28 / $0.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $0.09