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Minnesota 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
$0.35 / $0.35 / $0.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.88 / $1.27 / $2.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.73 / $0.91 / $0.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.53 / $2.39 / $2.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.84 / $0.95
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $2.18 / $2.74
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.68 / $1.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $0.84 / $1.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $0.84 / $1.51