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Florida 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
Facility
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $0.84 / $0.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $0.84 / $0.84
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.91 / $0.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $0.84 / $0.84
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $0.84 / $0.84