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West Virginia 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 $1$10%50%10th$1Professionalmedian $1 · 10th–90th $1$10%50%10th90th$1$0.5$1.0$2.0$5.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.45 / $1.48 / $1.91
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.56 / $0.56 / $0.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.83 / $1.05 / $1.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.83 / $0.83 / $3.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.12 / $1.12 / $1.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.56 / $0.83 / $0.89