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Wisconsin 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

Facilitymedian $1 · 10th–90th $0–$20%20%10th90th$1Professionalmedian $1 · 10th–90th $1–$20%20%10th90th$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
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $10.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.68 / $1.07 / $2.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.12 / $2.09 / $3.39
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.93 / $1.29
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.28 / $0.30 / $0.74
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.26 / $0.26 / $0.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.28 / $0.30 / $0.79
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $0.83 / $4.37
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $50.12 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.69 / $0.69 / $0.69
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.81 / $0.81 / $1.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $1.48 / $2.19
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.83 / $1.05 / $89.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $1.41 / $4.37
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.02 / $1.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.65 / $0.65 / $1.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $0.83 / $1.05