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Colorado rates for HCPCS Q0175

Perphenazine 4 Mg Oral Fda Approved Prescription Anti-Emetic For Use As A Complete Therapeutic Substitute For An Iv Anti- Emetic At The Time Of Chemotherapy Treatment Not To Exceed A 48 Hour Dosage Regimen (Special Coverage Instructions Apply)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.45 / $1.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.46 / $0.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.60 / $0.85 / $1.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $0.48 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.52 / $0.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.00 / $155.00 / $329.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.47 / $0.47