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Hawaii 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
$6.03 / $6.03 / $7.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.95
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $0.89 / $0.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $676.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.83 / $0.89