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Arkansas rates for HCPCS Q0173

Trimethobenzamide HCl, 250 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
Professional
Modifier
Low / Median / High Price
$1.95 / $1.95 / $1.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.87 / $0.87 / $0.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $0.87 / $0.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.63 / $0.83 / $0.83